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  1. Borrowed beauty? Understanding identity in Asian facial cosmetic surgery.Yves Saint James Aquino & Norbert Steinkamp - 2016 - Medicine, Health Care and Philosophy 19 (3):431-441.
    This review aims to identify (1) sources of knowledge and (2) important themes of the ethical debate related to surgical alteration of facial features in East Asians. This article integrates narrative and systematic review methods. In March 2014, we searched databases including PubMed, Philosopher’s Index, Web of Science, Sociological Abstracts, and Communication Abstracts using key terms “cosmetic surgery,” “ethnic*,” “ethics,” “Asia*,” and “Western*.” The study included all types of papers written in English that discuss the debate on rhinoplasty and blepharoplasty (...)
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  • Kidneys Save Lives: Markets Would Probably Help.Luke Semrau - 2014 - Public Affairs Quarterly 28 (1):71-93.
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  • Hacking the brain: brain–computer interfacing technology and the ethics of neurosecurity.Marcello Ienca & Pim Haselager - 2016 - Ethics and Information Technology 18 (2):117-129.
    Brain–computer interfacing technologies are used as assistive technologies for patients as well as healthy subjects to control devices solely by brain activity. Yet the risks associated with the misuse of these technologies remain largely unexplored. Recent findings have shown that BCIs are potentially vulnerable to cybercriminality. This opens the prospect of “neurocrime”: extending the range of computer-crime to neural devices. This paper explores a type of neurocrime that we call brain-hacking as it aims at the illicit access to and manipulation (...)
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  • Balancing Legitimate Critical-Care Interests: Setting Defensible Care Limits Through Policy Development.Jeffrey Kirby - 2016 - American Journal of Bioethics 16 (1):38-47.
    Critical-care decision making is highly complex, given the need for health care providers and organizations to consider, and constructively respond to, the diverse interests and perspectives of a variety of legitimate stakeholders. Insights derived from an identified set of ethics-related considerations have the potential to meaningfully inform inclusive and deliberative policy development that aims to optimally balance the competing obligations that arise in this challenging, clinical decision-making domain. A potential, constructive outcome of such policy engagement is the collaborative development of (...)
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  • The Limits to Setting Limits on Critical-Care Delivery: Response to Open Peer Commentaries on “Balancing Legitimate Critical-Care Interests: Setting Defensible Care Limits Through Policy Development”.Jeffrey Kirby - 2016 - American Journal of Bioethics 16 (1):5-8.
    Critical-care decision making is highly complex, given the need for health care providers and organizations to consider, and constructively respond to, the diverse interests and perspectives of a variety of legitimate stakeholders. Insights derived from an identified set of ethics-related considerations have the potential to meaningfully inform inclusive and deliberative policy development that aims to optimally balance the competing obligations that arise in this challenging, clinical decision-making domain. A potential, constructive outcome of such policy engagement is the collaborative development of (...)
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  • Saying something interesting about responsibility for health.Paul C. Snelling - 2012 - Nursing Philosophy 13 (3):161-178.
    The concept of responsibility for health is a significant feature of health discourse and public health policy, but application of the concept is poorly understood. This paper offers an analysis of the concept in two ways. Following an examination of the use of the word ‘responsibility’ in the nursing and wider health literature using three examples, the concept of ‘responsibility for health’ as fulfilling a social function is discussed with reference to policy documents from the UK. The philosophical literature on (...)
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  • The Patient preference predictor and the objection from higher-order preferences.Jakob Thrane Mainz - 2023 - Journal of Medical Ethics 49 (3):221-222.
    Recently, Jardas _et al_ have convincingly defended the patient preference predictor (PPP) against a range of autonomy-based objections. In this response, I propose a new autonomy-based objection to the PPP that is not explicitly discussed by Jardas _et al_. I call it the ‘objection from higher-order preferences’. Even if this objection is not sufficient reason to reject the PPP, the objection constitutes a pro tanto reason that is at least as powerful as the ones discussed by Jardas _et al._.
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  • Scaffolding informed consent.Dominic Wilkinson & Neil Levy - forthcoming - Journal of Medical Ethics.
    The principle of respecting patient autonomy underpins the concept and practice of informed consent. Yet current approaches to consent often ignore the ways in which the exercise of autonomy is deeply epistemically dependent.In this paper, we draw on philosophical descriptions of autonomy ‘scaffolding’ and apply them to informed consent in medicine. We examine how this relates to other models of the doctor–patient relationship and other theories (eg, the notion of relational autonomy). A focus on scaffolding autonomy reframes the justification for (...)
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  • Epistemic (in)justice, social identity and the Black Box problem in patient care.Muneerah Khan & Cornelius Ewuoso - 2024 - Medicine, Health Care and Philosophy 27 (2):227-240.
    This manuscript draws on the moral norms arising from the nuanced accounts of epistemic (in)justice and social identity in relational autonomy to normatively assess and articulate the ethical problems associated with using AI in patient care in light of the Black Box problem. The article also describes how black-boxed AI may be used within the healthcare system. The manuscript highlights what needs to happen to align AI with the moral norms it draws on. Deeper thinking – from other backgrounds other (...)
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  • Factors impacting the demonstration of relational autonomy in medical decision-making: A meta-synthesis.Thi Dung Le, Shih-Chun Lin, Mei-Chih Huang, Sheng-Yu Fan & Chi-Yin Kao - 2024 - Nursing Ethics 31 (5):714-738.
    Background Relational autonomy is an alternative concept of autonomy in which an individual is recognized as embedded into society and influenced by relational factors. Social context, including social location, political structure, and social forces, significantly influence an agent to develop and exercise autonomy skills. The relational approach has been applied in clinical practice to identify relational factors impacting patient autonomy and decision-making, yet there is a knowledge gap in how these factors influence the demonstration of relational autonomy in the context (...)
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  • Masculinity and the questions of “is” and “ought”: revisiting the definition of the notion of masculinity itself.Ognjen Arandjelovic - 2023 - Sexes 4 (4):448-461.
    The Oxford English Dictionary (OED) lists 1571 as the year of the first recorded use of the English word ‘masculinity’; the Ancient Greek ανδρεια (andreia), usually translated as ‘courage’, was also used to refer to manliness. The notion of manliness or masculinity is undoubtedly older still. Yet, despite this seeming familiarity, not only is the notion proving to be highly elusive, its understanding by the society being in a constant flux, but also one which is at the root of bitter (...)
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  • Care for Language: Etymology as a Continental Argument in Bioethics.Hub Zwart - 2021 - Journal of Bioethical Inquiry 18 (4):645-654.
    Emphasizing the importance of language is a key characteristic of philosophical reflection in general and of bioethics in particular. Rather than trying to eliminate the historicity and ambiguity of language, a continental approach to bioethics will make conscious use of it, for instance by closely studying the history of the key terms we employ in bioethical debates. Continental bioethics entails a focus on the historical vicissitudes of the key signifiers of the bioethical vocabulary, urging us to study the history of (...)
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  • Personal Identity and Self-Regarding Choice in Medical Ethics.Lucie White - 2020 - In Michael Kühler & Veselin L. Mitrović (eds.), Theories of the Self and Autonomy in Medical Ethics. Springer. pp. 31-47.
    When talking about personal identity in the context of medical ethics, ethicists tend to borrow haphazardly from different philosophical notions of personal identity, or to abjure these abstract metaphysical concerns as having nothing to do with practical questions in medical ethics. In fact, however, part of the moral authority for respecting a patient’s self-regarding decisions can only be made sense of if we make certain assumptions that are central to a particular, psychological picture of personal identity, namely, that patients will (...)
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  • Ethical Design of Intelligent Assistive Technologies for Dementia: A Descriptive Review.Marcello Ienca, Tenzin Wangmo, Fabrice Jotterand, Reto W. Kressig & Bernice Elger - 2018 - Science and Engineering Ethics 24 (4):1035-1055.
    The use of Intelligent Assistive Technology in dementia care opens the prospects of reducing the global burden of dementia and enabling novel opportunities to improve the lives of dementia patients. However, with current adoption rates being reportedly low, the potential of IATs might remain under-expressed as long as the reasons for suboptimal adoption remain unaddressed. Among these, ethical and social considerations are critical. This article reviews the spectrum of IATs for dementia and investigates the prevalence of ethical considerations in the (...)
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  • Self-diagnosis of psychiatric conditions as a threat to personal autonomy.Ilir Isufi - forthcoming - Philosophical Psychology.
    I argue that the recurring practice of self-diagnosis of psychiatric conditions such as autism spectrum disorder and attention-deficit/hyperactivity disorder on social media platforms poses a threat to personal autonomy understood as self-governance. My main argument is that self-diagnosis conducted without professional expertise is prone to lead to misdiagnosis, which can take the form of a distortion of self-image. This may result in pathologizing normal experiences and behaviors and the adoption of behavioral adjustments that harm those who engage in self-diagnosis. Acknowledging (...)
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  • Richard Dean: The Value of Humanity in Kant’s Moral Theory: Clarendon Press, Oxford, 2006, pp. x + 267. Cloth, £28.12.Victor Chidi Wolemonwu - 2020 - Medicine, Health Care and Philosophy 23 (2):221-226.
    This is critical review of Richard Dean’ book, The Value of Humanity in Kant’s Moral Theory. Dean’s book was evaluated, and some of his interpretations of Kant were critiqued. However, it concludes that Dean’s book is illuminating especially, as regards the distinction he made between consent and informed consent and their roles in biomedical practice.
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  • Lost in ‘Culturation’: medical informed consent in China.Vera Lúcia Raposo - 2019 - Medicine, Health Care and Philosophy 22 (1):17-30.
    Although Chinese law imposes informed consent for medical treatments, the Chinese understanding of this requirement is very different from the European one, mostly due to the influence of Confucianism. Chinese doctors and relatives are primarily interested in protecting the patient, even from the truth; thus, patients are commonly uninformed of their medical conditions, often at the family’s request. The family plays an important role in health care decisions, even substituting their decisions for the patient’s. Accordingly, instead of personal informed consent, (...)
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  • Ethics consultation and autonomy.Jukka Varelius - 2008 - Science and Engineering Ethics 14 (1):65-76.
    Services of ethics consultants are nowadays commonly used in such various spheres of life as engineering, public administration, business, law, health care, journalism, and scientific research. It has however been maintained that use of ethics consultants is incompatible with personal autonomy; in moral matters individuals should be allowed to make their own decisions. The problem this criticism refers to can be conceived of as a conflict between the professional autonomy of ethics experts and the autonomy of the persons they serve. (...)
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  • On challenges to respect for autonomous decision making in primary care.John Spicer, Sanjiv Ahluwalia & Rupal Shah - 2022 - Clinical Ethics 17 (4):458-464.
    Primary health care is characterised by timely and appropriate health care access, delivered continuously over time to a specific population, providing a comprehensive service, with coordination of care for those that need it. Practitioners deal with a multiplicity of clinical issues within longitudinal relationships, embedded in the context of families and communities. We propose that these aspects of primary care have a bearing on how matters of decision making are considered and implemented. Further, the standard account of autonomous decision making (...)
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  • Protection of Patient Autonomy via Consumer Protection Litigation: The Israeli Eltroxin Class Action as a Case Study.Tamar Gidron & Elad Schild - 2021 - Theoria 88 (6):1066-1085.
    The world famous Eltroxin saga of 2009–2011, which ignited heated public debates in Europe, Canada, and Australia, reveals the problematic nature of standalone autonomy protection cases. Eltroxin is a life-sustaining thyroid hormone replacement medicine used by millions worldwide; it was reformulated in 2008, and around 10% of patients were badly affected. Poor communication and lack of professional information triggered public hysteria as a global wave of complaints about harmful side effects, including hair loss, weight gain, extreme fatigue, headaches, diarrhoea, and (...)
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  • Should we have a right to refuse diagnostics and treatment planning by artificial intelligence?Iñigo de Miguel Beriain - 2020 - Medicine, Health Care and Philosophy 23 (2):247-252.
    Should we be allowed to refuse any involvement of artificial intelligence technology in diagnosis and treatment planning? This is the relevant question posed by Ploug and Holm in a recent article in Medicine, Health Care and Philosophy. In this article, I adhere to their conclusions, but not necessarily to the rationale that supports them. First, I argue that the idea that we should recognize this right on the basis of a rational interest defence is not plausible, unless we are willing (...)
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  • The development of assistive dementia technology that accounts for the values of those affected by its use.Oliver K. Burmeister - 2016 - Ethics and Information Technology 18 (3):185-198.
    Developing technology that accounts for values has been achieved in many areas, including security, gaming, finance, engineering, and many more. The main methodological approach has been that of value sensitive design. But most of the work to date has been on the first of its three stages. The focus of this article is on advances related to its second stage, empirical investigation, and in particular the impact of contextual understanding in that stage. Although lessons can be learnt from other domains, (...)
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  • Nurses’ perceptions of the use of restraint in pediatric somatic care.Mari Kangasniemi, Oili Papinaho & Anne Korhonen - 2014 - Nursing Ethics 21 (5):608-620.
    Background: The interest in the children’s role in pediatric care is connected to children’s health-related autonomy and informed consent in care. Despite the strong history of children’s rights, nurses’ role in the everyday nursing phenomenon, that is, restraint in somatic pediatric care, is still relatively seldom reported. Aim: The aim of this study is to describe nurses’ perceptions of the use of restraint in somatic pediatric care. The ultimate aim is to deepen the understanding of the phenomenon of restraint, whose (...)
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  • Shared decision-making and patient autonomy.Lars Sandman & Christian Munthe - 2009 - Theoretical Medicine and Bioethics 30 (4):289-310.
    In patient-centred care, shared decision-making is advocated as the preferred form of medical decision-making. Shared decision-making is supported with reference to patient autonomy without abandoning the patient or giving up the possibility of influencing how the patient is benefited. It is, however, not transparent how shared decision-making is related to autonomy and, in effect, what support autonomy can give shared decision-making. In the article, different forms of shared decision-making are analysed in relation to five different aspects of autonomy: (1) self-realisation; (...)
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  • Prescribing safe supply: ethical considerations for clinicians.Katherine Duthie, Eric Mathison, Helgi Eyford & S. Monty Ghosh - 2023 - Journal of Medical Ethics 49 (6):377-382.
    The COVID-19 pandemic has exacerbated the drug poisoning epidemic in a number of ways: individuals use alone more often, there is decreased access to harm reduction services and there has been an increase in the toxicity of the unregulated drug supply. In response to the crisis, clinicians, policy makers and people who use drugs have been seeking ways to prevent the worst harms of unregulated opioid use. One prominent idea is safe supply. One form of safe supply enlists clinicians to (...)
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  • Autonomy, Rationality, and Contemporary Bioethics.Jonathan Pugh - 2020 - Oxford, UK: Oxford University Press.
    Personal autonomy is often lauded as a key value in contemporary Western bioethics. Though the claim that there is an important relationship between autonomy and rationality is often treated as uncontroversial in this sphere, there is also considerable disagreement about how we should cash out the relationship. In particular, it is unclear whether a rationalist view of autonomy can be compatible with legal judgments that enshrine a patient's right to refuse medical treatment, regardless of whether the reasons underpinning the choice (...)
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  • The ‘opt-out’ approach to deceased organ donation in England: A misconceived policy which may precipitate moral harm.Tobias K. Cantrell - 2019 - Clinical Ethics 14 (2):63-69.
    In an effort to solve the shortage of transplantable organs, there have been several proposals to introduce an opt-out approach to deceased organ donation in England. In seeking to enact the so-called ‘opt-out proposal’ via an amendment to the Human Tissue Act 2004, The Organ Donation Bill 2017–19 represents the most recent attempt at such legal reform. Despite popular calls to the contrary, I argue in this paper that it would be premature for England, or, indeed, any country, to adopt (...)
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  • Remote Technologies and Filial Obligations at a Distance: New Opportunities and Ethical Challenges.Yi Jiao Tian, Fabrice Jotterand & Tenzin Wangmo - 2023 - Asian Bioethics Review 15 (4):479-504.
    The coupled growth of population aging and international migration warrants attention on the methods and solutions available to adult children living overseas to provide distance caregiving for their aging parents. Despite living apart from their parents, the transnational informal care literature has indicated that first-generation immigrants remain committed to carry out their filial caregiving obligations in extensive and creative ways. With functions to remotely access health information enabled by emergency, wearable, motion, and video sensors, remote monitoring technologies (RMTs) may thus (...)
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  • La valoración de la capacidad del paciente:ni depende del riesgo, ni es un mero resultado.José Luis Fernández Hernández, Pablo Herranz Hernández & Laura Segovia-Torres - 2021 - Dilemata 35:5-16.
    The notion that patients’ medical decision-making capacity depends on risk considerations has some acceptance in the bioethical literature. However, it arouses some criticism since it seems to give rise to paternalistic attitudes. In addition, the idea of capacity assessment as a collaborative space in which aid is given to the patient is emphasized so that they can decide about their life. It does not seem ethically acceptable to pose the evaluation as a simple observer report. Capacity assessment can sometimes be (...)
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  • Voices of moral authority: parents, doctors and what will actually help.Richard David William Hain - 2018 - Journal of Medical Ethics 44 (7):458-461.
    The public often believes that parents have a right to make medical decisions about their child. The idea that, in respect of children, doctors should do what parents tell them to do is problematic on the face of it. The effect of such a claim would be that a doctor who acted deliberately to harm a child would be making a morally correct decision, providing only that it is what the child’s parents said they wanted. That is so obviously nonsense (...)
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  • Patients’ Values and Desire for Autonomy: An Empirical Study from Poland.Agnieszka Olchowska-Kotala, Agata Strządała & Jarosław Barański - 2023 - Journal of Bioethical Inquiry 20 (3):409-419.
    There is a growing body of literature concerning factors that can influence patients’ perception, preferences, or expectations with regard to autonomy in making healthcare decisions. Although many factors responsible for the desire for autonomy in medical decision-making are already recognized, little is known about how the desire for autonomy is related to values, which refer to important goals of human actions. The present study was designed to determine the relationship between the desire for autonomy and basic personal values drawn on (...)
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  • Cost-equivalence and Pluralism in Publicly-funded Health-care Systems.Dominic Wilkinson & Julian Savulescu - 2018 - Health Care Analysis 26 (4):287-309.
    Clinical guidelines summarise available evidence on medical treatment, and provide recommendations about the most effective and cost-effective options for patients with a given condition. However, sometimes patients do not desire the best available treatment. Should doctors in a publicly-funded healthcare system ever provide sub-optimal medical treatment? On one view, it would be wrong to do so, since this would violate the ethical principle of beneficence, and predictably lead to harm for patients. It would also, potentially, be a misuse of finite (...)
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