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Kennedy Institute of Ethics Journal

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https://www.readbyqxmd.com/read/28366905/public-reasoning-and-health-care-priority-setting-the-case-of-nice
#1
Benedict Rumbold, Albert Weale, Annette Rid, James Wilson, Peter Littlejohns
Health systems that aim to secure universal patient access through a scheme of prepayments-whether through taxes, social insurance, or a combination of the two-need to make decisions on the scope of coverage that they guarantee: such tasks often falling to a priority-setting agency. This article analyzes the decision-making processes at one such agency in particular-the UK's National Institute for Health and Care Excellence (NICE)-and appraises their ethical justifiability. In particular, we consider the extent to which NICE's model can be justified on the basis of Rawls's conception of "reasonableness...
2017: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/28366904/the-duty-to-rescue-and-investigators-obligations
#2
Douglas MacKay, Tina Rulli
We examine current applications of the moral duty to rescue to justify clinical investigators' duties of ancillary care and standard of care to subjects in resource-poor settings. These applications fail to explain why investigators possess obligations to research participants, in particular, and not to people in need, in general. Further, these applications fail to recognize the normative significance of the institutional role of the investigators. We offer a positive account of the duty to rescue for investigators as institutional agents, with duties to populations rather than merely individuals...
2017: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/28366903/guardianship-and-clinical-research-participation-the-case-of-wards-with-disorders-of-consciousness
#3
Megan S Wright, Michael R Ulrich, Joseph J Fins
We review relevant federal law about research on human subjects and state laws on guardian authority to determine whether guardians can consent on behalf of their wards to participation in research. The Common Rule is silent on the issue as are most state guardianship laws. Our analysis shows significant variation in guardians' decision-making authority in the states that do regulate wards' participation in research.We consider how the appointment of guardians for patients with disorders of consciousness (DOC) impacts such patients' access to research...
2017: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/28366902/contextualized-autonomy-and-liberalism-broadening-the-lenses-on-complementary-and-alternative-medicines-in-preclinical-alzheimer-s-disease
#4
Eric Racine, John Aspler, Cynthia Forlini, Jennifer A Chandler
Given advances in Alzheimer's disease (AD) research, some experts have proposed a state of "preclinical" AD to describe asymptomatic individuals displaying certain biomarkers. The diagnostic accuracy of these biomarkers remains debated; however, given economic pressures, this "diagnosis" may eventually reach consumers. Since evidence-based prevention and treatment options remain only modestly effective, patients may turn to complementary and alternative medicine (CAM). We explore ethical challenges associated with CAM use in preclinical AD...
2017: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/28366901/editorial-note
#5
Rebecca Kukla
No abstract text is available yet for this article.
2017: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/27477198/editorial-note
#6
EDITORIAL
Rebecca Kukla
No abstract text is available yet for this article.
June 2016: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/27477196/nonegalitarian-social-responsibility-for-health-a-confucian-perspective-on-article-14-of-the-unesco-declaration-on-bioethics-and-human-rights
#7
Ruiping Fan
This essay offers a Confucian evaluation of Article 14 of the UNESCO Declaration on Bioethics and Human Rights, with a focus given to its statement that "the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being." It indicates that "a right to health" contained in the statement is open to two different interpretations, one radically egalitarian, another a decent minimum. It shows that Confucianism has strong moral considerations to reject the radical egalitarian interpretation, and argues that a Confucian nonegalitarian health distribution ethics of differentiated and graded love and obligation can reasonably be supported with a right to the decent minimum of health at the international level...
June 2016: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/27477195/on-physician-industry-relationships-and-unreasonable-standards-of-proof-for-harm-a-population-level-bioethics-approach
#8
Daniel Goldberg
The primary claim of this paper is that a widely used argument against obstructing, curtailing, or eliminating deep physician-industry relationships is deficient. The typical argument critiqued requires that proof that physician-industry relationships cause harm flows from randomized controlled trials. Chief among the deficiencies in this claim is the fact that this specific demand for proof of harm essentially guts the precautionary principle. In so doing, the typical argument neuters the basic justification for public health action...
June 2016: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/27477194/relativists-and-hypocrites-earp-on-genital-cutting
#9
Jamie Lindemann Nelson
No abstract text is available yet for this article.
June 2016: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/27477193/moral-hypocrisy-or-intellectual-inconsistency-a-historical-perspective-on-our-habit-of-placing-male-and-female-genital-cutting-in-separate-ethical-boxes
#10
Robert Darby
No abstract text is available yet for this article.
June 2016: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/27477192/equality-now-in-genital-reshaping-brian-earp-s-search-for-moral-consistency
#11
Richard A Shweder
No abstract text is available yet for this article.
June 2016: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/27477191/between-moral-relativism-and-moral-hypocrisy-reframing-the-debate-on-fgm
#12
Brian D Earp
The spectrum of practices termed "Female Genital Mutilation" (or FGM) by the World Health Organization is sometimes held up as a counterexample to moral relativism. Those who advance this line of thought suggest the practices are so harmful in terms of their physical and emotional consequences, as well as so problematic in terms of their sexist or oppressive implications, that they provide sufficient, rational grounds for the assertion of a universal moral claim--namely, that all forms of FGM are wrong, regardless of the cultural context...
June 2016: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/27157114/editorial-note
#13
Rebecca Kukla
No abstract text is available yet for this article.
March 2016: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/27157113/contributors
#14
(no author information available yet)
No abstract text is available yet for this article.
March 2016: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/27157112/placebo-effects-and-the-ethics-of-therapeutic-communication-a-pragmatic-perspective
#15
Marco Annoni, Franklin G Miller
In this article we explore the ethics of manipulating verbal information for the sake of influencing health outcomes through placebo and nocebo responses. Recent scientific research on placebo and nocebo effects has drawn attention to the ways in which communication by health professionals may modulate the symptoms of patients across an array of highly prevalent conditions such as pain, depression, anxiety, insomnia, irritable bowel syndrome, migraine, and Parkinson's disease. The positive and negative effects of clinicians' communication on patient outcomes pose important ethical issues, which we describe in this article under the label of "the ethics of therapeutic communication" (TC)...
March 2016: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/27157111/uncovering-metaethical-assumptions-in-bioethical-discourse-across-cultures
#16
Laura Specker Sullivan
Much of bioethical discourse now takes place across cultures. This does not mean that cross-cultural understanding has increased. Many cross-cultural bioethical discussions are marked by entrenched disagreement about whether and why local practices are justified. In this paper, I argue that a major reason for these entrenched disagreements is that problematic metaethical commitments are hidden in these cross-cultural discourses. Using the issue of informed consent in East Asia as an example of one such discourse, I analyze two representative positions in the discussion and identify their metaethical commitments...
March 2016: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/27157110/what-is-the-common-morality-really
#17
Benjamin Bautz
In recent editions of Tom Beauchamp and James Childress' Principles of Biomedical Ethics, their famous principles have been deployed as elements of the common morality recruited to anchor bioethical reasoning. In Principles, however, Beauchamp and Childress defend neither their assertions about the content, nor the normativity, of the common morality. Because these content and normativity claims form the backbone of their approach, both claims deserve substantive support if the project of Principles is to be completed...
March 2016: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/27157109/specifying-specification
#18
Norbert Paulo
This paper tackles the accusation that applied ethics is no serious academic enterprise because it lacks theoretical bracing. It does so in two steps. In the first step I introduce and discuss a highly acclaimed method to guarantee stability in ethical theories: Henry Richardson's specification. The discussion shows how seriously ethicists take the stability of the connection between the foundational parts of their theories and their further development as well as their "application" to particular problems or cases...
March 2016: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/28533499/putting-patient-autonomy-in-its-proper-place-professional-norm-guided-medical-decision-making
#19
Thomas Huddle
The recommended model for patient participation in medical decision-making is the shared decision-making model (SDM). That model is ambiguous as to how much physician influence on patient decision-making is desirable or permissible. Most discussants suggest that physician influence on medical decisions, while allowable, should be limited. Empirical studies of medical decision-making have shown that much medical practice does not conform to the SDM. The author recommends a different model for medical decision-making, "professional norm-guided medical decision-making," which, he suggests, much medical practice actually follows...
2016: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/28533498/the-missions-of-national-commissions-mapping-the-forms-and-functions-of-bioethics-advisory-bodies
#20
Harald Schmidt, Jason L Schwartz
The findings, conclusions, and recommendations of national ethics commissions (NECs) have received considerable attention throughout the 40-year history of these groups in the United States and worldwide. However, the procedures or types of argument by which these bodies arrive at their decisions have received far less scrutiny. This paper explores how the diversity of ethical principles, concepts, or theories is featured in publications or decisions of these bodies, with particular emphasis on the need for NECs to be inclusive of pluralist positions that typically exist in contemporary democracies...
2016: Kennedy Institute of Ethics Journal
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