What makes a medical intervention invasive?
The classification of medical interventions as either invasive or non-invasive is commonly regarded to be morally important. On the most commonly endorsed account of invasiveness, a medical intervention is invasive if and only if it involves either breaking the skin (‘incision’) or inserting an object into the body (‘insertion’). Building on recent discussions of the concept of invasiveness, we show that this standard account fails to capture three aspects of existing usage of the concept of invasiveness in relation to medical interventions—namely, (1) usage implying that invasiveness comes in...
Source: Journal of Medical Ethics - March 20, 2024 Category: Medical Ethics Authors: De Marco, G., Simons, J., Forsberg, L., Douglas, T. Tags: Feature article Source Type: research
Reassessing the VaxTax
To counter the imbalance in vaccine distribution during the COVID-19 pandemic, Albertsen and more recently Germani et al have suggested a new system of taxation coined as ‘VaxTax’ that would force higher-income countries to fund the access of low-income and middle-income countries (LMICs) to new vaccines in times of pandemic. I will argue that this idea faces numerous challenges of ethical, sociopolitical and economical nature that may hinder any effort to solve the numerous health challenges that LMICs face. I argue that while it is an interesting idea, it is neither sufficient nor will it ever be easily imple...
Source: Journal of Medical Ethics - March 20, 2024 Category: Medical Ethics Authors: Petrovic, N. Tags: COVID-19 Current controversy Source Type: research
Medical ethics, equity and social justice
As John McMillan notes in January’s editorial,1 many countries are reflecting on how they responded to the COVID-19 pandemic, what went wrong and how responses to such system shocks can be better managed in the future. However, while it is tempting to think that the COVID-19 pandemic is over and that what is now needed is a reflection on how countries could have responded better, some of the underlying issues and problems COVID-19 both highlighted and created are still with us. The legacy of the pandemic has continued particularly for healthcare workers at all levels, who have had to continue providing services with ...
Source: Journal of Medical Ethics - March 20, 2024 Category: Medical Ethics Authors: Frith, L. Tags: Editorial Source Type: research
Igwebuike: an African concept for an inclusive medical ethics
Igwebuike is a traditional knowledge system undergirded by the metaphysical assumption that the world is a totality of interconnected and interrelated entities.1–4 African scholars in West Africa often invoke igwebuike to make sense of African ethical, social and political perspectives that are grounded in the theory of Afro-communitarianism. Afro-communitarianism is primarily a socioethical theory that is concerned with the articulation of the moral relationship between the individual and the community. The term igwebuike is derived from the Igbo root words igwe (number), bu (is) and ike (strength). Thus, the term i...
Source: Journal of Medical Ethics - February 20, 2024 Category: Medical Ethics Authors: Cordeiro-Rodrigues, L., Agada, A. Tags: Words Source Type: research
First among equals? Adaptive preferences and the limits of autonomy in medical ethics
Respect for patient autonomy is a central principle of medical ethics. However, there are important unresolved questions about the characteristics of an autonomous decision, and whether some autonomous preferences should be subject to more scrutiny than others.
In this paper, we consider whether inappropriately adaptive preferences—preferences that are based on and that may perpetuate social injustice—should be categorised as autonomous in a way that gives them normative authority. Some philosophers have argued that inappropriately adaptive preferences do not have normative authority, because they are only a re...
Source: Journal of Medical Ethics - February 20, 2024 Category: Medical Ethics Authors: Pennings, S., Symons, X. Tags: Editor's choice Extended essay Source Type: research
Human equality and the impermissibility of abortion: a response to Bozzo
I have recently offered a defence of human equality, and consequently an argument against abortion. This has been objected to by Bozzo, on the grounds that my account of human equality is unclear and could be grounded in utilitarian or Kantian ethics, that my account struggles to ground the permissibility of therapeutic abortions, and that my proposed foundation for human equality itself is parasitic on a scalar property which generates the same difficulties I am attempting to solve. I provide an account of human equality which cannot easily be grounded in utilitarianism or Kantianism, offer a variety of defences of therap...
Source: Journal of Medical Ethics - February 20, 2024 Category: Medical Ethics Authors: Miller, C. Tags: Response Source Type: research
Abortion and the basis of equality: a reply to Miller
Miller has recently argued that the standard liberal and moderate positions on abortion are incapable of grounding the claim that ‘all non-disabled adult humans are equal’. The reason, he claims, is such accounts base the intrinsic moral worth of a human being on some property (or set of properties) which comes in degrees. In contrast, he argues that moral equality must reside in some binary property, such as the property of being human. In this paper, I offer three criticisms of Miller’s position. (Source: Journal of Medical Ethics)
Source: Journal of Medical Ethics - February 20, 2024 Category: Medical Ethics Authors: Bozzo, A. Tags: Response Source Type: research
Gain-of-function research and model organisms in biology
So-called ‘gain-of-function’ (GOF) research is virological research that results in a virus substantially more virulent or transmissible than its wild antecedent. GOF research has been subject to ethical analysis in the past, but the methods of GOF research have to date been underexamined by philosophers in these analyses. Here, we examine the typical animal used in influenza GOF experiments, the ferret, and show how despite its longstanding use, it does not easily satisfy the desirable criteria for an animal model. We then discuss the limitations of the ferret model, and how those epistemic limitations bear on...
Source: Journal of Medical Ethics - February 20, 2024 Category: Medical Ethics Authors: Evans, N. G., Pence, C. H. Tags: Open access Original research Source Type: research
Undermining autonomy and consent: the transformative experience of disease
This article applies Paul’s theory of transformative experience and its expansion by Carel and Kidd to investigate the implications for medical ethics. It leads to the very uncomfortable conclusion that disease involves transformative experiences in ways that can reduce people’s rational decision-making ability and undermine the basic principle of respect for autonomy and the moral rule of informed consent. While such cases are limited, they are crucial for medical ethics and health policy and deserve more attention and further scrutiny. (Source: Journal of Medical Ethics)
Source: Journal of Medical Ethics - February 20, 2024 Category: Medical Ethics Authors: Hofmann, B. Tags: Original research Source Type: research
Addressing bias in artificial intelligence for public health surveillance
Components of artificial intelligence (AI) for analysing social big data, such as natural language processing (NLP) algorithms, have improved the timeliness and robustness of health data. NLP techniques have been implemented to analyse large volumes of text from social media platforms to gain insights on disease symptoms, understand barriers to care and predict disease outbreaks. However, AI-based decisions may contain biases that could misrepresent populations, skew results or lead to errors. Bias, within the scope of this paper, is described as the difference between the predictive values and true values within the model...
Source: Journal of Medical Ethics - February 20, 2024 Category: Medical Ethics Authors: Flores, L., Kim, S., Young, S. D. Tags: Original research Source Type: research
Abortion restrictions: the case for conscientious non-compliance on the part of providers
This paper offers a qualified defence of physician non-compliance with antiabortion legislation in the wake of the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization. The paper examines two ethically troubling trends of post-Dobbs legislation: narrow and vague maternal health exemption clauses and mandatory reporting of miscarriages in jurisdictions where patients may criminal prosecution for medically induced abortions. It then examines and defends a professional obligation on the part of physicians to comply with the law. This obligation, however, is defeasible. The paper then argues tha...
Source: Journal of Medical Ethics - February 20, 2024 Category: Medical Ethics Authors: Randall, P., Mago, J. Tags: Original research Source Type: research
'False hope in assisted reproduction: the normative significance of the external outlook and moral negotiation
Despite the frequent invocation of ‘false hope’ and possible related moral concerns in the context of assisted reproduction technologies, a focused ethical and conceptual problematisation of this concept seems to be lacking. We argue that an invocation of ‘false hope’ only makes sense if the fulfilment of a desired outcome (eg, a successful fertility treatment) is impossible, and if it is attributed from an external perspective. The evaluation incurred by this third party may foreclose a given perspective from being an object of hope. However, this evaluation is not a mere statistical calculation or...
Source: Journal of Medical Ethics - February 20, 2024 Category: Medical Ethics Authors: Accoe, D., Segers, S. Tags: Original research Source Type: research
The revised International Code of Medical Ethics: responses to some important questions
We thank our commentators for their thoughtful responses to our paper1 covering among other issues the relationships of ethics law and professional codes, the tensions between ethical universalism and cultural relativism and the phenomenon of moral judgement required when ethical norms conflict, including the norms of patient care versus obligations to others both now and in the future. Although the comments deserve more extensive discussion, in what follows we respond briefly to specific aspects of each commentary and remind readers that professional codes of ethics are necessarily brief and that the International Code of...
Source: Journal of Medical Ethics - February 20, 2024 Category: Medical Ethics Authors: Parsa-Parsi, R. W., Gillon, R., Wiesing, U. Tags: Commentary Source Type: research
Can medical ethics truly be independent of law?
Parsa-Parsi et al assert that the International Code of Medical Ethics (ICoME) provides a professional standard that overrides conflicting national legal norms.1 While this claim is made in the context of laws that require doctors to participate in ‘acts of torture, or other cruel, inhuman, or degrading practices and punishments’ (para10 of ICoME), the underlying premise that medical ethics supersedes law requires scrutiny. It is clear that medical ethics and law are linked inextricably, but there is unresolved debate about the sequence of this interaction: should ethics shape law; or is it the converse? Import...
Source: Journal of Medical Ethics - February 20, 2024 Category: Medical Ethics Authors: Sarela, A. I. Tags: Commentary Source Type: research
Dear WMA, please better engage LMICs and say more about environmental sustainability
Parsa-Parsi et al bring attention to the World Medical Association (WMA) and transparency to its International Code of Medical Ethics (ICoME) revisions.1 We value their report and the revised ICoME but explain here that the ICoME cannot reflect consensus among all WMA members, or the wider medical profession, given structural and epistemic injustices that restrain low-income and middle-income country (LMIC) physicians from participating in activities such as WMA revisions. Such injustices overlook experiences and contributions of those from LMICs and marginalised groups, hindering their access to and influence within medic...
Source: Journal of Medical Ethics - February 20, 2024 Category: Medical Ethics Authors: Macpherson, C. C., Cyrus-Murden, A. Tags: Commentary Source Type: research
