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Journal of Medical Ethics

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https://www.readbyqxmd.com/read/28526778/nudges-in-a-post-truth-world
#1
Neil Levy
Nudges-policy proposals informed by work in behavioural economics and psychology that are designed to lead to better decision-making or better behaviour-are controversial. Critics allege that they bypass our deliberative capacities, thereby undermining autonomy and responsible agency. In this paper, I identify a kind of nudge I call a nudge to reason, which make us more responsive to genuine evidence. I argue that at least some nudges to reason do not bypass our deliberative capacities. Instead, use of these nudges should be seen as appeals to mechanisms partially constitutive of these capacities, and therefore as benign (so far as autonomy and responsible agency are concerned)...
May 19, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28507223/should-neurotechnological-treatments-offered-to-offenders-always-be-in-their-best-interests
#2
Thomas Søbirk Petersen
The paper critically discusses the moral view that neurotechnological behavioural treatment for criminal offenders should only be offered if it is in their best interests. First, I show that it is difficult to apply and assess the notion of the offender's best interests unless one has a clear idea of what 'best interests' means. Second, I argue that if one accepts that harmful punishment of offenders has a place in the criminal justice system, it seems inconsistent not to accept the practice of offering offenders treatment even when the state will harm them in applying the treatment...
May 15, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28507222/meeting-the-goal-of-concurrent-adolescent-and-adult-licensure-of-hiv-prevention-and-treatment-strategies
#3
Michelle Hume, Linda L Lewis, Robert M Nelson
The ability of adolescents to access safe and effective new products for HIV prevention and treatment is optimised by adolescent licensure at the same time these products are approved and marketed for adults. Many adolescent product development programmes for HIV prevention or treatment products may proceed simultaneously with adult phase III development programmes. Appropriately implemented, this strategy is not expected to delay licensure as information regarding product efficacy can often be extrapolated from adults to adolescents, and pharmacokinetic properties of drugs in adolescents are expected to be similar to those in adults...
May 15, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28507221/allocation-of-antiretroviral-drugs-to-hiv-infected-patients-in-togo-perspectives-of-people-living-with-hiv-and-healthcare-providers
#4
Lonzozou Kpanake, Paul Clay Sorum, Etienne Mullet
AIM: To explore the way people living with HIV and healthcare providers in Togo judge the priority of HIV-infected patients regarding the allocation of antiretroviral drugs. METHOD: From June to September 2015, 200 adults living with HIV and 121 healthcare providers living in Togo were recruited for the study. They were presented with stories of a few lines depicting the situation of an HIV-infected patient and were instructed to judge the extent to which the patient should be given priority for antiretroviral drugs...
May 15, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28495832/identity-personhood-and-the-law-charles-foster-and-jonathan-herring-springer-2017-isbn-978-3-319-53458-9-70-pp
#5
Charles Foster, Jonathan Herring
No abstract text is available yet for this article.
May 11, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28483804/towards-coherent-data-policy-for-biomedical-research-with-elsi-2-0-orchestrating-ethical-legal-and-social-strategies
#6
J Patrick Woolley
As the recent inaugural Ethical, Legal, and Social Issues (ELSI) 2.0 conference made clear, the effects of information communication technology (ICT) are pervasive in biomedical research. Data initiatives are arising in all corners of biomedicine. Data sharing efforts already promised to surpass even the ambitious goals of the National Human Genome Research Institute, only 5 years after publication of its 10-year vision. ELSI research was established, in part, to address challenges of open data access and data sharing...
May 8, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28473627/everything-in-moderation-even-hype-learning-from-vaccine-controversies-to-strike-a-balance-with-crispr
#7
Shawna Benston
The ease and applicability of CRISPR/Cas9--a new and precise gene editing and reproductive technology--have garnered hype and heightened concern about its potential 'unprecedented and horrific consequences' and have led many scientific leaders to call for a moratorium on its research and use. CRISPR appears distinctly more controversial than previous technological innovations (genetic or otherwise), with a greater reach and speed of human treatment and enhancement; however, we have seen similarly inflated hopes and fears in response to other medical innovations for well over a century...
May 4, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28450403/pathways-to-genetic-parenthood-for-same-sex-couples
#8
Timothy F Murphy
Researchers are pursuing various ways to synthesise human male and female gametes, which would be useful for people facing infertility. Some people are unable to conceive children with their partner because one of them is infertile in the sense of having an anatomical or physiological deficit. Other people-in same sex couples-may not be individually infertile but situationally infertile in relation to one another. Segers et al have described a pathway towards synthetic gametes that would rely on embryonic stem cells, rather than somatic cells...
April 27, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28450402/designing-methuselah-an-ethical-argument-against-germline-genetic-modification-to-prolong-human-longevity
#9
Isabelle L Robertson
Precise editing of the human germline has been considered an unlikely and an unethical proposition. Recently, tools to edit the human germline have been developed and it is now a realistic prospect. Consequently, the ethical arguments around prohibiting human genome editing need to be re-evaluated. It is anticipatable that using it to eradicate disease-causing mutations will be acceptable if clinical risks can be shown to be sufficiently low. Some go further and advocate that genetically 'enhancing' humans will also be permissible...
April 27, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28438784/professional-and-conscience-based-refusals-the-case-of-the-psychiatrist-s-harmful-prescription
#10
Morten Magelssen
By way of a case story, two common presuppositions in the academic debate on conscientious objection in healthcare are challenged. First, the debate typically presupposes a sharp division between conscience-based refusals based on personal core moral beliefs and refusals based on professional (eg, medical) reasons. Only the former might involve the moral gravity to warrant accommodation. The case story challenges this division, and it is argued that just as much might sometimes be at stake morally in refusals based on professional reasons...
April 24, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28438783/mistakes-and-missed-opportunities-regarding-cosmetic-surgery-and-conscientious-objection
#11
Toni C Saad
In her paper 'Cosmetic surgery and conscientious objection', Minerva rightly identifies cosmetic surgery as an interesting test case for the question of conscientious objection in medicine. Her treatment of this important subject, however, seems problematic. It is argued that Minerva's suggestion that a doctor has a prima facie duty to satisfy patient preferences even against his better clinical judgment, which we call Patient Preference Absolutism, must be regarded with scepticism. This is because (1) it overlooks an important distinction regarding autonomy's meaning and place in clinical practice, and (2) it makes obsolete the important concepts of expert clinical judgment and beneficence...
April 24, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28432196/the-case-against-libertarian-arguments-for-compulsory-vaccination
#12
Justin Bernstein
In a recent paper in this journal, Jason Brennan correctly notes that libertarians struggle to justify a policy of compulsory vaccination. The most straightforward argument that justifies compulsory vaccination is that such a policy promotes welfare. But libertarians cannot make this argument because they claim that the state is justified only in protecting negative rights, not in promoting welfare. I consider two representative libertarian attempts to justify compulsory vaccination, and I argue that such arguments are unsuccessful...
April 21, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28424230/a-quiet-revolution-in-organ-transplant-ethics
#13
Arthur Caplan, Duncan Purves
A quiet revolution is occurring in the field of transplantation. Traditionally, transplants have involved solid organs such as the kidney, heart and liver which are transplanted to prevent recipients from dying. Now transplants are being done of the face, hand, uterus, penis and larynx that aim at improving a recipient's quality of life. The shift away from saving lives to seeking to make them better requires a shift in the ethical thinking that has long formed the foundation of organ transplantation. The addition of new forms of transplants requires doctors, patients, regulators and the public to rethink the risk and benefit ratio represented by trade-offs between saving life, extending life and risking the loss of life to achieve improvements in the quality of life...
April 19, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28408724/from-protection-to-entitlement-selecting-research-subjects-for-early-phase-clinical-trials-involving-breakthrough-therapies
#14
Nancy S Jecker, Aaron G Wightman, Abby R Rosenberg, Douglas S Diekema
Our goals are to (1) set forth and defend a multiprinciple system for selecting individuals who meet trial eligibility criteria to participate in early phase clinical trials testing chimeric antigen receptor (CAR T-cell) for acute lymphoblastic leukaemia when demand for participation exceeds spaces available in a trial; (2) show the relevance of these selection criteria to other breakthrough experimental therapies; (3) argue that distinct distributive justice criteria apply to breakthrough experimental therapies, standard research and healthcare and (4) argue that as evidence of benefit increases, the emphasis of justice in research shifts from protecting subjects from harm to ensuring fair access to benefits...
April 13, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28396558/vaccine-testing-for-emerging-infections-the-case-for-individual-randomisation
#15
Nir Eyal, Marc Lipsitch
During the 2014-2015 Ebola outbreak in Guinea, Liberia and Sierra Leone, many opposed the use of individually randomised controlled trials to test candidate Ebola vaccines. For a raging fatal disease, they explained, it is unethical to relegate some study participants to control arms. In Zika and future emerging infections, similar opposition may hinder urgent vaccine research, so it is best to address these questions now. This article lays out the ethical case for individually randomised control in testing vaccines against many emerging infections, including lethal infections in low-income countries, even when at no point in the trial do the controls receive the countermeasures being tested...
April 10, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28389527/patient-autonomy-and-professional-expertise-in-decisions-near-the-end-of-life-commentary-on-francis-kamm
#16
Robert D Truog
No abstract text is available yet for this article.
April 7, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28385733/institutions-as-an-ethical-locus-of-research-prioritisation
#17
Luke Gelinas, Holly Fernandez Lynch, Barbara Bierer, I Glenn Cohen
No abstract text is available yet for this article.
April 6, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28381583/the-sensitivity-argument-against-child-euthanasia
#18
Geoff Keeling
Is there a moral difference between euthanasia for terminally ill adults and euthanasia for terminally ill children? Luc Bovens considers five arguments to this effect, and argues that each is unsuccessful. In this paper, I argue that Bovens' dismissal of the sensitivity argument is unconvincing.
April 5, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28356492/the-moral-bioenhancement-of-psychopaths
#19
Elvio Baccarini, Luca Malatesti
We argue that the mandatory moral bioenhancement of psychopaths is justified as a prescription of social morality. Moral bioenhancement is legitimate when it is justified on the basis of the reasons of the recipients. Psychopaths expect and prefer that the agents with whom they interact do not have certain psychopathic traits. Particularly, they have reasons to require the moral bioenhancement of psychopaths with whom they must cooperate. By adopting a public reason and a Kantian argument, we conclude that we can justify to a psychopath being the recipient of mandatory moral bioenhancement because he has a reason to require the application of this prescription to other psychopaths...
March 29, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28356491/should-gratitude-be-a-requirement-for-access-to-live-organ-donation
#20
Monica Escher, Monique Lamuela-Naulin, Catherine Bollondi, Paola Flores Menendez, Samia A Hurst
Gratitude is both expected and problematic in live organ donation. Are there grounds to require it, and to forbid access to live donor transplantation to a recipient who fails to signal that he feels any form of gratitude? Recipient gratitude is not currently required for organ donation, but it is expected and may be a moral requirement. Despite this, we argue that making it a condition for live organ transplantation would be unjustified. It would constitute a problematic and disproportionate punishment for perceived immoral behaviour on the part of the recipient...
March 29, 2017: Journal of Medical Ethics
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