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Kennedy Institute of Ethics Journal

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https://www.readbyqxmd.com/read/30369509/bioethics-and-the-hypothesis-of-extended-health
#1
Nicolae Morar, Joshua August Skorburg
Dominant views about the nature of health and disease in bioethics and the philosophy of medicine have presumed the existence of a fixed, stable, individual organism as the bearer of health and disease states, and as such, the appropriate target of medical therapy and ethical concern. However, recent developments in microbial biology, neuroscience, the philosophy of cognitive science, and social and personality psychology have produced a novel understanding of the individual and its fluid boundaries. Drawing on converging evidence from these disciplines, and following recent research in public health, we argue that certain features of our biological and social environment can be so tightly integrated as to constitute a unit of care extending beyond the intuitive boundaries of skin and skull...
2018: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/30369508/an-argument-against-drug-testing-welfare-recipients
#2
Mary Jean Walker, James Franklin
Programs of drug testing welfare recipients are increasingly common in US states and have been considered elsewhere. Though often intensely debated, such programs are complicated to evaluate because their aims are ambiguous-aims like saving money may be in tension with aims like referring people to treatment. We assess such programs using a proportionality approach, which requires that for ethical acceptability a practice must be reasonably likely to meet its aims, sufficiently important in purpose as to outweigh harms incurred, and lower in costs than feasible alternatives...
2018: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/30369507/too-close-to-the-knives-children-s-rights-parental-authority-and-best-interests-in-the-context-of-elective-pediatric-surgeries
#3
Maggie Taylor
This paper advances a novel conception of the child's best interest in regard to pediatric surgeries that do not promote the preventive or therapeutic health needs of children, namely elective pediatric surgeries (EPS). First, children's capacity for decision making is examined, and the best decision-making model for EPS is identified as the Best Interest Standard. What follows is a discussion of the interests of children in the context of EPS, the correlation of fundamental interests to rights, and guidelines for weighing children's competing interests...
2018: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/30369506/sex-categorization-in-medical-contexts-a-cautionary-tale
#4
Lauren Freeman, Saray Ayala López
The goal of this paper is to problematize the use of sex categories in medical contexts. We question the benefits of categorizing all individuals as either male or female in medical contexts and argue that we should focus instead on the relevant sex-related properties of patients. Contrary to what many people believe, the classificatory system by which sexed bodies are neatly divided into male and female is anything but clear. An abundance of evidence shows that a binary sex system does not accurately describe the reality of human bodies...
2018: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/30369505/editorial-note
#5
Rebecca Kukla
No abstract text is available yet for this article.
2018: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/30100600/she-touched-me-five-snapshots-of-adult-sexual-violations-of-black-boys
#6
Tommy J Curry, Ebony A Utley
Too often the idea of young Black boys as sexually aggressive or criminally assaultive displaces the idea that they can be victims at all. As such, Black boys are not theorized or researched as victims of sexual violations in current gender literatures. Instead they are almost exclusively represented as perpetrators of sexual violence, not victims of it. This study examines five snapshots of Black men who were victims of sexual violations as young boys. Our findings indicate that Black males are uniquely at risk for sexual impropriety and statutory rape, primarily via older women and teenage girl female-perpetrators (although risk also includes same-sex violations)...
2018: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/30100599/reconceptualizing-autonomy-for-bioethics
#7
Lisa Dive, Ainsley J Newson
Autonomy plays a central role in bioethics, but there is no consensus as to how we should understand this concept. This paper critically considers three different conceptions of autonomy: the default conception prevalent in bioethics literature; a broader procedural account of autonomy drawing on moral philosophical approaches; and a substantive, perfectionist account. Building on Rebecca Walker's critique of the default conception of autonomy, we will argue that a substantive, perfectionist approach both fulfils Walker's criteria for a conception of autonomy in bioethics and lends itself to application in practical scenarios...
2018: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/30100598/effective-reparation-for-the-guatemala-s-t-d-experiments-a-victim-centered-approach
#8
Bethany Spielman
Discussion of reparations for U.S.-Guatemala STD experiments of the 1940s and 50s should be informed by a range of international and U.S. reparation experiences, so that features that impair the effectiveness of repair are avoided, and features that enhance effectiveness of repair are emulated. Two features have contributed to the effectiveness or ineffectiveness of repair elsewhere but have not been critically examined in relation to the Guatemalan experiments: Whether experimental subjects or their families have the opportunity to participate in reparations processes, and whether any group of experimental subjects is intentionally denied recognition...
2018: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/30100597/if-the-facts-were-not-untruths-their-implications-were-sponsorship-bias-and-misleading-communication
#9
Daniel Steel
Sponsorship bias occurs when the financial interests of funders of scientific research influence claims made by scientists, especially in peer-reviewed publications. This article examines the relationship between sponsorship bias and misleading claims, understood as claims that are not necessarily false but which encourage those exposed to them to infer false conclusions. Misleading claims are relevant to how the term "bias" should be understood and thereby to evaluating a recent dispute about whether there is evidence of sponsorship bias in clinical research on statins...
2018: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/30100596/editorial-note
#10
EDITORIAL
Rebecca Kukla
No abstract text is available yet for this article.
2018: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/29628452/an-ethical-analysis-of-the-support-trial-addressing-challenges-posed-by-a-pragmatic-comparative-effectiveness-randomized-controlled-trial
#11
Austin R Horn, Charles Weijer, Jeremy Grimshaw, Jamie Brehaut, Dean Fergusson, Cory E Goldstein, Monica Taljaard
The SUPPORT trial highlights ethical challenges raised by comparative effectiveness randomized controlled trials (ceRCTs) involving one or more usual care interventions. Debate about the SUPPORT trial has focused on whether study interventions posed "reasonably foreseeable risks" to enrolled infants and, thereby, reflects a preoccupation with U.S. regulations. As ceRCTs are conducted globally, our analysis of the SUPPORT trial is grounded in internationally accepted ethical principles. We argue that the central ethical issue raised by the SUPPORT trial is the following: should the SUPPORT trial interventions be conceptualized as practice, or research? The answer to this question has important implications for "downstream" ethical requirements-including whether the usual care interventions in ceRCTs require research ethics committee review, undergo harm-benefit analysis, and are included in informed consent documents-and it is antecedent to the development of ethical guidance for ceRCTs...
2018: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/29628451/assessing-rehabilitation-eligibility-of-older-patients-an-ethical-analysis-of-the-impact-of-bias
#12
Josephine Najem, Priscilla Lam Wai Shun, Maude Laliberté, Vardit Ravitsky
Hospitalized older patients are more vulnerable to physical or cognitive functional decline. Inpatient rehabilitation programs improve significantly their functional status and may prevent their admission to nursing homes. While inpatient rehabilitation institutions have established admission criteria that can be seen as objective, the risk of bias remains and raises the question of equitable access for more vulnerable populations such as older patients. This paper reviews some established eligibility criteria for inpatient rehabilitation by examining a framework used in Montreal, Québec, Canada for assessing rehabilitation eligibility and by applying this framework to a case study...
2018: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/29628450/support-for-voluntary-euthanasia-with-no-logical-slippery-slope-to-non-voluntary-euthanasia
#13
Steven Daskal
This paper demonstrates that acceptance of voluntary euthanasia does not generate commitment to either non-voluntary euthanasia or euthanasia on request. This is accomplished through analysis of John Keown's and David Jones's slippery slope arguments, and rejection of their view that voluntary euthanasia requires physicians to judge patients as better off dead. Instead, voluntary euthanasia merely requires physicians to judge patients as within boundaries of appropriate deference. This paper develops two ways of understanding and defending voluntary euthanasia on this model, one focused on the independent value of patients' autonomy and the other on the evidence of well-being provided by patients' requests...
2018: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/29628449/ethical-guidelines-for-genetic-research-on-alcohol-addiction-and-its-applications
#14
Audrey R Chapman, Adrian Carter, Jonathan M Kaplan, Kylie Morphett, Wayne Hall
Research on the genomic correlates to addiction raises ethical issues in a number of different domains. In this paper, we evaluate the status of genetic research on alcohol dependence as background to addressing the ethical issues raised in conducting research on addiction and the application of that research to the formulation of public policies. We conclude that genetic testing is not yet ready for use in the prediction of alcohol dependence liability. Pharmacogenetic testing for responses to treatments may have more clinical utility, although additional research is required to demonstrate utility and cost-effectiveness...
2018: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/29628448/editorial-note
#15
Rebecca Kukla
No abstract text is available yet for this article.
2018: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/29307881/what-makes-health-care-special-an-argument-for-health-care-insurance
#16
L Chad Horne
While citizens in a liberal democracy are generally expected to see to their basic needs out of their own income shares, health care is treated differently. Most rich liberal democracies provide their citizens with health care or health care insurance in kind. Is this "special" treatment justified? The predominant liberal account of justice in health care holds that the moral importance of health justifies treating health care as special in this way. I reject this approach and offer an alternative account...
2017: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/29307880/can-the-brain-dead-be-harmed-or-wronged-on-the-moral-status-of-brain-death-and-its-implications-for-organ-transplantation
#17
Michael Nair-Collins
The majority of transplantable human organs are retrieved from patients declared dead by neurological criteria, or "brain-dead." Since brain death is considered to be sufficient for death, the procurement of vital organs is not considered to harm or wrong such patients. In this essay I argue that this is not the case. After distinguishing welfare, experiential, and investment interests, and defining precedent autonomy and surviving interests, I argue that brain-dead patients can be, and many are, harmed and wronged by organ procurement as currently practiced...
2017: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/29307879/the-obligation-to-provide-information-where-valid-consent-is-not-needed
#18
Tom Walker
Accounts of consent in medical ethics typically assume that consent plays the same role irrespective of the type of treatment. In this paper I argue that this assumption is false. Because of this, obligations to provide information to patients that stem from the need for consent to be valid will not apply to all types of treatment. This does not mean that there are no reasons to provide such information. The second part of the paper maps out what these reasons are and argues that they are grounded in the obligation of beneficence and a duty to warn, not in considerations of respect for autonomy...
2017: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/29307878/disabled-by-design-justifying-and-limiting-parental-authority-to-choose-future-children-with-pre-implantation-genetic-diagnosis
#19
Joseph Stramondo
Often, ethical analysis of Pre-Implantation Genetic Diagnosis occupies one of two positions in a moral dichotomy. On the one hand, we have a deep suspicion of the technology as directly leading to eugenics, which is assumed to be a negative consequence; and on the other, we have a vigorous enthusiasm for the technology as a means toward creating better offspring, where "better" is assumed to mean, at minimum, non-disabled. For my part, I eschew both of these positions and attempt to break this dichotomy wide open by maintaining that future parents are not morally required to use PGD to select some vision of an objectively "best" child, but should be permitted to use PGD to select embryos according to their own conception of the good life, even if that conception of the good life includes disability...
2017: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/29307877/editorial-note
#20
Rebecca Kukla
No abstract text is available yet for this article.
2017: Kennedy Institute of Ethics Journal
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