Should Doctors Offer Biomarker Testing to Those Afraid to Develop Alzheimer ’s Dementia?
AbstractAn increasing number of people seek medical attention for mild cognitive symptoms at older age, worried that they might develop Alzheimer ’s disease. Some clinical practice guidelines suggest offering biomarker testing in such cases, using a brain scan or a lumbar puncture, to improve diagnostic certainty about Alzheimer’s disease and enable an earlier diagnosis. Critics, on the other hand, point out that there is no effective Alz heimer treatment available and argue that biomarker tests lack clinical validity. The debate on the ethical desirability of biomarker testing is currently polarized; advocates and opp...
Source: Journal of Bioethical Inquiry - March 19, 2022 Category: Medical Ethics Source Type: research
The Principle of the Primacy of the Human Subject and Minimal Risk in Non-Beneficial Paediatric Research
AbstractNon-beneficial paediatric research is vital to improving paediatric healthcare. Nevertheless, it is also ethically controversial. By definition, subjects of such studies are unable to give consent and they are exposed to risks only for the benefit of others, without obtaining any clinical benefits which could compensate those risks. This raises ethical concern that children participating in non-beneficial research are treated instrumentally; that they are reduced to mere instruments for the benefit of science and society. But this would make the research incompatible with the widely endorsed principle of the primac...
Source: Journal of Bioethical Inquiry - February 28, 2022 Category: Medical Ethics Source Type: research
HIV Testing Autonomy: The Importance of Relationship Factors in HIV Testing to People in Lusaka and Chongwe, Zambia
This study explores the views of participants from Zambia. In-depth and focus group discussions were conducted at various locations in Lusaka and Chongwe, Zambia. Participants came from various demographics, including people living with HIV (PLHIV), healthcare professionals and workers, policymakers, pregnant women, churchgoers, teachers, rural-based persons, and police officers. Data were manually analysed by conducting inductive and deductive thematic analyses. Results show that participants were not in favour of HIV policies that promote personal autonomy at the expense of pursuit of the common good. Participants viewed...
Source: Journal of Bioethical Inquiry - February 24, 2022 Category: Medical Ethics Source Type: research
An Ethical Overview of the CRISPR-Based Elimination of Anopheles gambiae to Combat Malaria
AbstractApproximately a quarter of a billion people around the world suffer from malaria each year. Most cases are located in sub-Saharan Africa whereAnopheles gambiae mosquitoes are the principal vectors of this public health problem. With the use of CRISPR-based gene drives, the population of mosquitoes can be modified, eventually causing their extinction. First, we discuss the moral status of the organism and argue that using genetically modified mosquitoes to combat malaria should not be abandoned based on some moral value of A. gambiae. Secondly, we argue that environmental impact studies should be performed to obtain...
Source: Journal of Bioethical Inquiry - February 17, 2022 Category: Medical Ethics Source Type: research
An Ethical Framework for Visitation of Inpatients Receiving Palliative Care in the COVID-19 Context
AbstractHuman connection is universally important, particularly in the context of serious illness and at the end of life. The presence of close family and friends has many benefits when death is close. Hospital visitation restrictions during the Coronavirus (COVID-19) pandemic therefore warrant careful consideration to ensure equity, proportionality, and the minimization of harm. The Australian and New Zealand Society for Palliative Medicine COVID-19 Special Interest Group utilized the relevant ethical and public health principles, together with the existing disease outbreak literature and evolving COVID-19 knowledge, to g...
Source: Journal of Bioethical Inquiry - February 17, 2022 Category: Medical Ethics Source Type: research
The Thailand Cave Rescue: General Anaesthesia in Unique Circumstances Presents Ethical Challenges for the Rescue Team
AbstractIn 2018, the remarkable rescue of twelve young boys and their football coach trapped in a flooded cave in Thailand captured worldwide attention. The rescue required the boys to be dived out of the cave system while fully anaesthetized which presented unique practical and ethical challenges for the rescue team. Major departures from normal anaesthetic practice were required. Taking anaesthetized children underwater was unprecedented, complex, and dangerous. To do this underground in a flooded cave meant the risks were extreme. Using a principlist approach, this essay will outline the rescue plan highlighting the eth...
Source: Journal of Bioethical Inquiry - February 14, 2022 Category: Medical Ethics Source Type: research
Enhancing Gender
AbstractTransgender healthcare faces a dilemma. On the one hand, access to certain medical interventions, including hormone treatments or surgeries, where desired, may be beneficial or even vital for some gender dysphoric trans people. But on the other hand, access to medical interventions typically requires a diagnosis, which, in turn, seems to imply the existence of a pathological state —something that many transgender people reject as a false and stigmatizing characterization of their experience or identity. In this paper we argue that developments from the human enhancement debate can help clarify or resolve some of ...
Source: Journal of Bioethical Inquiry - February 7, 2022 Category: Medical Ethics Source Type: research
The Reasonableness Standard for Conscientious Objection in Healthcare
AbstractIn complex, pluralistic societies, different views concerning the moral duties of healthcare professionals inevitably exist: according to some accounts, doctors can and should cooperate in performing abortion or physician-assisted suicide, while according to others they should always defend human life and protect their patients ’ health. It is argued that the very plurality of responses presently given to questions such as these provides a liberal argument in favour of conscientious objection (CO), as an attempt to deal with moral diversity by protecting both the professionals’ claim to moral integrity and the ...
Source: Journal of Bioethical Inquiry - February 1, 2022 Category: Medical Ethics Source Type: research
Addressing Suffering in Infants and Young Children Using the Concept of Suffering Pluralism
AbstractDespite the central place of suffering in medical care, suffering in infants and nonverbal children remains poorly defined. There are epistemic problems in the detection and treatment of suffering in infants and normative problems in determining what is in their best interests. A lack of agreement on definitions of infant suffering leads to misunderstanding, mistrust, and even conflict amongst clinicians and parents. It also allows biases around intensive care and disability to (mostly unconsciously) affect medical decision-making on behalf of infants. In this paper, I propose the concept of suffering pluralism, wh...
Source: Journal of Bioethical Inquiry - January 28, 2022 Category: Medical Ethics Source Type: research
Sperling, Daniel. 2019. Suicide tourism. Oxford and New York: Oxford University Press. ISBN 978-0-19-882545-6
(Source: Journal of Bioethical Inquiry)
Source: Journal of Bioethical Inquiry - January 28, 2022 Category: Medical Ethics Source Type: research
Respecting Older Adults: Lessons from the COVID-19 Pandemic
AbstractThe COVID-19 pandemic has exacerbated many social problems and put the already vulnerable, such as racial minorities, low-income communities, and older individuals, at an even greater risk than before. In this paper we focus on older adults ’ well-being during the COVID-19 pandemic and show that the risk-mitigation measures presumed to protect them, alongside the generalization of an ageist public discourse, exacerbated the pre-existing marginalization of older adults, disproportionately affecting their well-being. This paper shows t hat states have duties to adopt and put into practice redress measures to compen...
Source: Journal of Bioethical Inquiry - January 27, 2022 Category: Medical Ethics Source Type: research
COVID-19 and Biomedical Experts: When Epistemic Authority is (Probably) Not Enough
This article relies on two case studies: (i) herd immunity (UK) and (ii) restricted access to ventilators for disabled people (USA). These case studies are discussed as examples of experts ’ recommendations that have not been widely accepted, though they were made within the boundaries of expert epistemic authority. While the fundamental contribution of biomedical experts in devising public health policies during the COVID-19 pandemic is fully recognized, this paper intends to discu ss potential issues and limitations that may arise when adopting a strict expert-based approach. By drawing attention to the interests of mi...
Source: Journal of Bioethical Inquiry - January 17, 2022 Category: Medical Ethics Source Type: research
Rethinking the Precedent Autonomy, Current Minimal Autonomy, and Current Well-Being in Medical Decisions for Persons with Dementia
AbstractAs patient autonomy expands, a highly controversial issue has emerged. Should the advance directives (ADs) of refusing life-saving treatments or requesting euthanasia of persons with dementia (PWDs) who express changed minds or are often in a happy state be fulfilled? There are two autonomy-related positions. The mainstream position in philosophical discussions supports the priority of ADs based on precedent autonomy. Buchanan and Brock, and Dworkin represent this view. The other position supports the priority of PWDs ’ current wishes based on minimal autonomy represented by Jaworska. By rethinking the theoretica...
Source: Journal of Bioethical Inquiry - January 11, 2022 Category: Medical Ethics Source Type: research
The Ethical Unjustifications of COVID-19 Triage Committees
AbstractThe ever-debated question of triage and allocating the life-saving ventilator during the COVID-19 pandemic has been repeatedly raised and challenged within the ethical community after shortages propelled doctors before life and death decisions (Anderson-Shaw and Zar2020; Huxtable2020; Jongepier 2020; Peterson, Largent, and Karlawish2020). The British Medical Association ’s ethical guidance highlighted the possibility of an initial surge of patients that would outstrip the health system’s ability to deliver care “to existing standards,” where utilitarian measures have to be applied, and triage decisions need...
Source: Journal of Bioethical Inquiry - December 29, 2021 Category: Medical Ethics Source Type: research
Which Vaccine? The Cost of Religious Freedom in Vaccination Policy
AbstractWe discuss whether and under what conditions people should be allowed to choose which COVID-19 vaccine to receive on the basis of personal ethical views. The problem arises primarily with regard to some religious groups ’ concerns about the connection between certain COVID-19 vaccines and abortion. Vaccines currently approved in Western countries make use of foetal cell lines obtained from aborted foetuses either at the testing stage (Pfizer/BioNTech and Moderna vaccines) or at the development stage (Oxford/Astra Zeneca vaccine). The Catholic Church’s position is that, if there are alternatives, Catholic people...
Source: Journal of Bioethical Inquiry - December 23, 2021 Category: Medical Ethics Source Type: research
