Biomedical Ethics

Edited by L. Syd M Johnson (SUNY Upstate Medical University)
Assistant editor: Tyler John (Longview Philanthropy)
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History/traditions: Biomedical Ethics

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90841 found
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  1. A Principle-Based Approach to Visual Identification Systems for Hospitalized People with Dementia.T. V. Brigden, C. Mitchell, K. Kuberska & A. Hall - forthcoming - Journal of Bioethical Inquiry:1-14.
    A large proportion of hospital inpatients are affected by cognitive impairment, posing challenges in the provision of their care in busy, fast-paced acute wards. Signs and symbols, known as visual identifiers, are employed in many U.K. hospitals with the intention of helping healthcare professionals identify and respond to the needs of these patients. Although widely considered useful, these tools are used inconsistently, have not been subject to full evaluation, and attract criticism for acting as a shorthand for a routinized response. (...)
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  2. Does the Duty of Rescue support a moral obligation to vaccinate? Seasonal influenza and the Institutional Duty of Rescue.Abigail Sophie Harmer - forthcoming - Journal of Medical Ethics.
    Seasonal influenza poses a significant public health risk in many countries worldwide. Lower immunity and less influenza virus circulating during the pandemic has resulted in a significant increase in cases since the lifting of COVID-19 restrictions in 2022. The seasonal influenza vaccine offers effective protection and is safe for use in large numbers of the population. This article asserts that a moral obligation to vaccinate against influenza can be understood as an Institutional Duty of Rescue. The traditional understanding of the (...)
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  3. How clinicians can respond when family members question a proxy/surrogate's judgment and decisional capacity.Gregoire Calon & Katherine Drabiak - forthcoming - Clinical Ethics.
    Many state laws specify procedures for determining surrogate or proxy decision-makers for end-of-life care in the absence of an advance directive, living will, or other designation. Some laws also set forth criteria that the decision-maker must follow when making medical decisions for an incapacitated patient and determining whether to withdraw life-sustaining treatment. This article provides analysis of a medical ethics case on the question of how to address family allegations that the proxy decision-maker suffers from dementia and is unable to (...)
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  4. Fertility preservation in prepubertal female patients: Medical and ethical considerations of offering ovarian tissue cryopreservation in pediatric patients.Giulia Adele Dinicola - forthcoming - Clinical Ethics.
    In the USA, one child in 285 children is diagnosed with cancer every year, but thanks to improvements in medicine, the survival rate has reached 80%. However, cancer treatments, such as chemotherapy and radiation, are likely to affect their fertility later in life, limiting their ability to conceive. To reduce this risk, ovarian tissue cryopreservation is a surgical procedure that allows the ovarian tissue to be retrieved and cryopreserved in order to be reimplanted back into the abdomen and restore ovarian (...)
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  5. Ética en investigaciones con seres humanos vulnerables en el marco de la Bioética. ¿Conocimientos para quién?Cintia Rodríguez Garat - 2022 - Divulgatio. Perfiles Académicos de Posgrado 7 (19):99-116.
    En este ensayo nos proponemos realizar algunas consideraciones argumentativas breves sobre la ética en investigaciones con seres humanos vulnerables. Para ello, examinaremos el conocido caso de Tuskegee (Alabama), ocurrido entre los años 1932-1972, en el que 600 personas afroamericanas fueron inoculadas con sífilis sin su consentimiento. Luego, desde una postura crítica, abordaremos el caso desde tres perspectivas bioéticas. En primer lugar, lo analizaremos desde el plano jurídico-normativo, luego desde el principialismo formulado por Tom Beauchamp y James Childress, y finalmente, desde (...)
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  6. Abordajes teórico-normativos en torno a políticas sanitarias y a problemáticas vivenciadas por mujeres mapuce en la atención sanitaria.Cintia Rodríguez Garat - 2021 - Divulgatio. Perfiles Académicos de Posgrado 6 (16):1-29.
    En este artículo se plantean las bases del marco ético-normativo que intervienen en la atención sanitaria de las mujeres en general, y de las mujeres mapuce, en particular. Posteriormente, se realiza un abordaje de las mujeres indígenas analizando su situación concreta, a partir de considerar de manera crítica la confluencia intersectorial de distintos sistemas opresivos que articulan las relaciones de género, clase y etnia. Para ello, el planteo se centrará en el estudio de esta problemática desde la perspectiva feminista latinoamericana, (...)
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  7. Sharing a medical decision.Coos Engelsma - forthcoming - Medicine, Health Care and Philosophy:1-12.
    During the last decades, shared decision making (SDM) has become a very popular model for the physician-patient relationship. SDM can refer to a process (making a decision in a shared way) and a product (making a shared decision). In the literature, by far most attention is devoted to the process. In this paper, I investigate the product, wondering what is involved by a medical decision being shared. I argue that the degree to which a decision to implement a medical alternative (...)
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  8. Legal and ethical principles governing the use of artificial intelligence in radiology services in South Africa.Irvine Sihlahla, Dusty-Lee Donnelly, Beverley Townsend & Donrich Thaldar - forthcoming - Developing World Bioethics.
    Artificial intelligence (AI) will drastically change the healthcare system. Radiology is one speciality that is most affected as AI algorithms are increasingly used in diagnostic imaging. AI‐enhanced health technologies will, inter alia, increase workflow efficiency, improve diagnostic accuracy, reduce healthcare‐related costs, and help alleviate medical personnel shortages in under‐resourced settings. However, the development of AI‐enhanced technologies in healthcare is fraught with legal, ethical, and human rights concerns. Currently, the use of AI in South African healthcare is not governed by sui (...)
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  9. From book to bedside? A critical perspective on the debate about “translational bioethics”.Alexander Kremling, Jan Schildmann & Marcel Mertz - forthcoming - Bioethics.
    The concept of “translational bioethics” has received considerable attention in recent years. Most publications draw an analogy to translational medicine and describe bioethical research that aims at implementing and evaluating ethical interventions. However, current accounts of translational bioethics are often rather vague and seem to differ with regard to conceptual and methodological assumptions. It is not clear and scarcely analyzed what exactly “translation” in the field of bioethics means, in particular regarding goals and processes so that it is justified to (...)
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  10. Consideration and Disclosure of Group Risks in Genomics and Other Data-Centric Research: Does the Common Rule Need Revision?Carolyn Riley Chapman, Gwendolyn P. Quinn, Heini M. Natri, Courtney Berrios, Patrick Dwyer, Kellie Owens, Síofra Heraty & Arthur L. Caplan - forthcoming - American Journal of Bioethics:1-14.
    Harms and risks to groups and third-parties can be significant in the context of research, particularly in data-centric studies involving genomic, artificial intelligence, and/or machine learning technologies. This article explores whether and how United States federal regulations should be adapted to better align with current ethical thinking and protect group interests. Three aspects of the Common Rule deserve attention and reconsideration with respect to group interests: institutional review board (IRB) assessment of the risks/benefits of research; disclosure requirements in the informed (...)
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  11. Spheres of Morality: The Ethical Codes of the Medical Profession.Samuel Doernberg & Robert Truog - 2023 - American Journal of Bioethics 23 (12):8-22.
    The medical profession contains five “spheres of morality”: clinical care, clinical research, scientific knowledge, population health, and the market. These distinct sets of normative commitments require physicians to act in different ways depending on the ends of the activity in question. For example, a physician-scientist emphasizes patients’ well-being in clinic, prioritizes the scientific method in lab, and seeks to maximize shareholder returns as a board member of a pharmaceutical firm. Physicians increasingly occupy multiple roles in healthcare and move between them (...)
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  12. Public Engagement through Inclusive Deliberation: The Human Genome International Commission and Citizens’ Juries.Naomi Scheinerman - 2022 - American Journal of Bioethics 23 (12):66-76.
    In this paper, I take seriously calls for public engagement in human genome editing decision-making by endorsing the convening of a “Citizens Jury” in conjunction with the International Commission on the Clinical Use of Human Germline Genome Editing’s next summit scheduled for March 6–8, 2023. This institutional modification promises a more inclusive, deliberative, and impactful form of engagement than standard bioethics engagement opportunities, such as comment periods, by serving both normative and political purposes in the quest to offer moral guidance (...)
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  13. Time to Treat the Climate and Nature Crisis as One Indivisible Global Health Emergency.Kamran Abbasi, Parveen Ali, Virginia Barbour, Thomas Benfield, Kirsten Bibbins-Domingo, Gregory E. Erhabor, Stephen Hancocks, Richard Horton, Laurie Laybourn-Langton, Robert Mash, Peush Sahni, Wadeia Mohammad Sharief, Paul Yonga & Chris Zielinski - 2023 - American Journal of Bioethics 23 (12):1-4.
    Over 200 health journals call on the United Nations, political leaders, and health professionals to recognise that climate change and biodiversity loss are one indivisible crisis and must be tackle...
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  14. Spheres of Morality: Is There a Point?Brian M. Jackson & Matthew K. Wynia - 2023 - American Journal of Bioethics 23 (12):5-7.
    Since physicians began to formally professionalize in the 19th century, we have sought to set ourselves apart from other occupations through the adoption (and variable enforcement) of codes of ethi...
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  15. Varieties of Citizen Engagement in Deliberation about Biotechnology.Michael A. Neblo & Avery White - 2023 - American Journal of Bioethics 23 (12):90-92.
    Deliberative democrats would appear to face something of a dilemma: They want to secure robust citizen input into the policy process, especially on the big, controversial issues that affect people’...
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  16. Goldilocks and the Thanatron: A Response to Open Peer Commentaries.Daryl Pullman - 2023 - American Journal of Bioethics 23 (12):4-6.
    I want to begin this brief response by thanking all of those who took the time to read and reflect upon this piece. There were many thoughtful and thought provoking responses and I have learned fro...
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  17. Response to Open Peer Commentaries on “Public Engagement through Inclusive Deliberation: The Human Genome International Commission and Citizens’ Juries”.Naomi Scheinerman - 2022 - American Journal of Bioethics 23 (12):1-3.
    I greatly appreciate the open peer commentary authors’ thoughtful engagement with my proposal to include a Citizens’ Jury (CJ) at the level of the International Commission when exploring ethical re...
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  18. Against the Equality of Moral Spheres in Healthcare.Jonathan Herington & Lainie Friedman Ross - 2023 - American Journal of Bioethics 23 (12):23-25.
    In a recent paper, Doernberg and Truog identify that physicians must routinely navigate a set of distinct “moral spheres”—clinical care, research, population health and the market.1 While the conce...
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  19. Ethics at the Edges: Normative Considerations When Spheres of Morality Overlap.D. Micah Hester - 2023 - American Journal of Bioethics 23 (12):32-34.
    With their target article, “Spheres of Morality…,” Dornberg and Truog (2023) have given us a careful analytic framework for distinguishing moral concerns among different domains involved in medical...
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  20. Not All Publics Are the Same—A Note on Power, Diversity, and Lived Expertise in Public Deliberation.Yves Saint James Aquino, Stacy Carter & Chris Degeling - 2023 - American Journal of Bioethics 23 (12):85-87.
    Scheinerman (2023) proposes that at the Human Genome Editing Initiative international summit (held in March 2023) there should have been a parallel, separate Citizens’ Jury, and that the Human Geno...
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  21. We Need Role Fidelity and Integrity to Avoid Moral Compartmentalization, Not Sphere or Role Moralities.Lauris Christopher Kaldjian - 2023 - American Journal of Bioethics 23 (12):49-51.
    The article by Doernberg and Truog (2023) suggests that five different medical spheres have five distinctive sets of moral norms based on the ends of those spheres, implying that different roles in...
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  22. What Is a Physician? Navigating Incommensurable Spheres of Role Morality.Bryan Pilkington - 2023 - American Journal of Bioethics 23 (12):44-46.
    In their compelling argument for the use of role morality as a means to aid physicians in navigating potential conflicts of interest, Doernberg and Truog (2023) posit the existence of distinct sphe...
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  23. Inclusion by Invitation Only? Public Engagement beyond Deliberation in the Governance of Innovative Biotechnology.Callum Gunn & Karin Jongsma - 2023 - American Journal of Bioethics 23 (12):79-82.
    From their interpretation of the Australian Citizens’ Jury on genome editing, Scheinerman (2023) concludes that inclusive and diverse deliberative processes of public engagement have salient benefi...
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  24. Disentangling Normativity and Ethics.Binesh Hass & Dominic Wilkinson - 2023 - American Journal of Bioethics 23 (12):29-31.
    Why should we obey the rules that constitute a code of conduct? If a rule is justified by conclusive moral reasons, then those reasons are sufficient, from a rational point of view (rather than, sa...
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  25. Competing Duties and Professional Roles.Rosamond Rhodes - 2023 - American Journal of Bioethics 23 (12):25-28.
    I heartily agree with Sam Doernberg and Robert Troug’s claims that there are important differences between “general morality” and medical ethics, and that in some instances they issue contradictory...
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  26. Intersecting Moral Spheres, and the Ethical Structures and Functional Roles of Military Medicine: Frameworks in—and for—Reciprocal Rectitude.Megan Applewhite, Owen Sisbarro & James Giordano - 2023 - American Journal of Bioethics 23 (12):60-62.
    Pro Doernberg and Truog (2023), we recognize and acknowledge five spheres of morality in medicine. We posit that these spheres represent domains of practical engagement, which, as the authors note,...
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  27. Circumscribing Morality: The Spheres and Their Limits.Grayson R. Jackson & Jeffrey S. Farroni - 2023 - American Journal of Bioethics 23 (12):39-41.
    Doernberg and Truog (2023) claim that physicians increasingly serve in multiple roles outside the traditional clinical encounter, roles with various and divergent aims that nonetheless “invoke the...
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  28. An Opportunity to Reconsider Fiduciary Framing in Medicine.Jennifer L. Herbst - 2023 - American Journal of Bioethics 23 (12):46-48.
    In their target article, Doernberg and Truog (2023) correctly recognize that the doctor-patient relationship is considered a “fiduciary” relationship (i.e., other-regarding rather than self-interes...
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  29. Occupying Multiple Practical Identities instead of Moving between the Moral Spheres: An Alternative Perspective on Physicians’ Professional Ethics.Henk Jasper van Gils-Schmidt & Sabine Salloch - 2023 - American Journal of Bioethics 23 (12):42-44.
    In depicting five “spheres of morality” occupied by physicians Doernberg and Troug provide an impressive analysis on physicians’ various commitments and role conflicts which are excellently illustr...
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  30. A Decolonial Critique to the Spheres of Morality in the Medical Profession.Gabriela Arguedas-Ramirez - 2023 - American Journal of Bioethics 23 (12):62-65.
    This commentary has three parts. The first one is based on fundamental questions in the field of philosophy of medicine, linked to relevant epistemological and ethical considerations in the analysi...
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  31. Physicians’ Professional Role in Clinical Care: AI as a Change Agent.Giorgia Pozzi & Jeroen van den Hoven - 2023 - American Journal of Bioethics 23 (12):57-59.
    Doernberg and Truog (2023) provide an insightful analysis of the role of medical professionals in what they call spheres of morality. While their framework is useful for inquiring into the moral de...
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  32. Public Engagement with Human Germline Editing Requires Specification.Boy Vijlbrief, Sam Riedijk & Eline M. Bunnik - 2023 - American Journal of Bioethics 23 (12):77-79.
    Scheinerman (2023) proposes a Citizen’s Jury on human germline genome editing (HGGE) to promote more inclusive public engagement, agenda setting and governance. She argues these juries should work...
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  33. Use Dignity, Not Its Parasites or Offspring.Charles Foster - 2023 - American Journal of Bioethics 23 (12):54-56.
    Doernberg and Truog (2023) propose a complex scheme for identifying the ethical issues at stake in various medical situations.The complexity of their scheme illustrates the difficulties that arise...
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  34. Beyond Incommensurability and Appropriateness: Integrating the Telos of Medicine and Addressing Compartmentalization in the Spheres of Morality Framework.Ariel Guersenzvaig - 2023 - American Journal of Bioethics 23 (12):34-36.
    Doernberg and Truog (2023) present a thoughtful analysis of the ethical tensions that arise from physicians increasingly occupying “multiple roles in healthcare”1 I take no issue with the classific...
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  35. In Defense of Expert Knowledge in Bioethical Discussions on Human Genome Editing.Tomasz Rzepiński - 2023 - American Journal of Bioethics 23 (12):93-95.
    The development of innovative biomedical technologies that use gene editing tools opens up new possibilities in the treatment of rare diseases, as well as diseases that were not previously treated...
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  36. There Is Only One Sphere of Morality.Michael Nair-Collins - 2023 - American Journal of Bioethics 23 (12):51-53.
    Physicians participate in several kinds of activities in their professional lives. Clinical care is the core function of the physician. Medical education is overwhelmingly oriented toward this func...
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  37. What Kind of Popular Participation Does Bioethics Need? Clarifying the Ends of Public Engagement through Randomly Selected Mini-Publics.Jin K. Park, Samuel Bagg & Anna C. F. Lewis - 2023 - American Journal of Bioethics 23 (12):82-84.
    In a recent Target Article Naomi Scheinerman (2023a) has offered an important and compelling call to institutionalize popular participation for heritable genome engineering through the inclusion of...
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  38. Virtue Ethics and the Spheres of Morality Framework.Christopher Bobier - 2023 - American Journal of Bioethics 23 (12):37-38.
    Doernberg and Truog (2023) offer a “spheres of morality framework” (11) to illuminate ethical conflicts and improve ethical decision making in healthcare. A sphere of morality is the collection of...
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  39. It Takes Two to Tango: Fostering Engagement Within Citizen Juries.Brenda Bogaert & Ralf J. Jox - 2023 - American Journal of Bioethics 23 (12):88-90.
    A citizen’s jury brings together a mix of citizens from different socio-economic groups who deliberate on a particular policy issue over a number of days. Since their development in the 1970s in th...
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  40. Healthcare strikes and the ethics of voting in ballots.Ben Saunders - forthcoming - Journal of Medical Ethics.
    There has been much discussion of the justifiability of strikes by healthcare workers, but comparatively little discussion of the political processes through which strikes occur. This article focuses on the Trade Union Act 2016, which currently governs strike ballots in the UK. This legislation has important implications for healthcare workers being balloted on strikes (or other forms of industrial action). The article first explains the legal requirements for a strike mandate and illustrates how votes in strike ballots can be counterproductive, (...)
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  41. Undocumented migrants’ access to healthcare in Sweden, and the impact of Act 2013:407.Anna O’Sullivan - forthcoming - Nursing Ethics.
    Background Research shows that undocumented migrants have difficulties in accessing healthcare. Act 2013:407 came into force in 2013 and entitled undocumented migrants to healthcare that cannot be deferred. To date, studies about undocumented migrants’ access to care in Sweden and the impact of Act 2013:407 are sparse. Hence, the aim of this study was to describe professionals’ experiences of access to healthcare for undocumented migrants in Sweden and the impact of Act 2013:407. Methods A qualitative design with semi-structured interviews was (...)
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  42. Ethical dilemmas faced by healthcare teachers during the COVID-19 pandemic.Monika Koskinen, Yvonne Hilli, Tuulikki Keskitalo, Merle Talvik, Ann-Helen Sandvik, Kari Marie Thorkildsen, Maria Skyvell-Nilsson, Meeri Koivula & Jekaterina Šteinmiller - forthcoming - Nursing Ethics.
    Background Previous studies have shown that the rapid transition to emergency remote teaching due to the COVID-19 pandemic was challenging for healthcare teachers in many ways. This sudden change made them face ethical dilemmas that challenged their values and ethical competence. Research aim This study aimed to explore and gain a deeper understanding of the ethical dilemmas healthcare teachers faced during the COVID-19 pandemic. Research design This was an inductive qualitative study using a hermeneutic approach. Semi-structured interviews were conducted and (...)
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  43. Leaving no one behind: successful ageing at the intersection of ageism and ableism.Merle Weßel & Elisabeth Langmann - 2023 - Philosophy, Ethics, and Humanities in Medicine 18 (1):1-11.
    BackgroundThe concept of ‘successful ageing’ has been a prominent focus within the field of gerontology for several decades. However, despite the widespread attention paid to this concept, its intersectional implications have not been fully explored yet. This paper aims to address this gap by analyzing the potential ageist and ableist biases in the discourse of successful ageing through an intersectional lens.MethodA critical feminist perspective is taken to examine the sensitivity of the discourse of successful ageing to diversity in societies. The (...)
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  44. Admitting the heterogeneity of social inequalities: intersectionality as a (self-)critical framework and tool within mental health care.Florian Funer - 2023 - Philosophy, Ethics, and Humanities in Medicine 18 (1):1-9.
    Inequities shape the everyday experiences and life chances of individuals at the margins of societies and are often associated with lower health and particular challenges in accessing quality treatment and support. This fact is even more dramatic for those individuals who live at the nexus of different marginalized groups and thus may face multiple discrimination, stigma, and oppression. To address these multiple social and structural disadvantages, intersectional approaches have recently gained a foothold, especially in the public health field. This study (...)
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  45. Animating Clinical Ethics: A Structured Method to Teach Ethical Analysis Through Movies.Diego Real de Asúa, Karmele Olaciregui Dague, Andrés Arriaga & Benjamin Herreros - 2023 - HEC Forum 35 (4):325-335.
    Movies can serve valuable didactic purposes teaching clinical ethics to medical students. However, using film sequences as means to develop critical thinking is not a straightforward task. There is a significant gap in the literature regarding how to analyse the ethical content embedded in these clips systematically, in a way that facilitates the students’ transition from anecdotal reflections to abstract thinking. This article offers a pedagogical proposal to approach the ethical analysis of film sequences in a systematic fashion. This structured (...)
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  46. Clinical Ethics Consultation During the First COVID-19 Pandemic Surge at an Academic Medical Center: A Mixed Methods Analysis.Kimberly S. Erler, Ellen M. Robinson, Julia I. Bandini, Eva V. Regel, Mary Zwirner, Cornelia Cremens, Thomas H. McCoy, Fred Romain & Andrew Courtwright - 2023 - HEC Forum 35 (4):371-388.
    While a significant literature has appeared discussing theoretical ethical concerns regarding COVID-19, particularly regarding resource prioritization, as well as a number of personal reflections on providing patient care during the early stages of the pandemic, systematic analysis of the actual ethical issues involving patient care during this time is limited. This single-center retrospective cohort mixed methods study of ethics consultations during the first surge of the COVID 19 pandemic in Massachusetts between March 15, 2020 through June 15, 2020 aim to (...)
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  47. A Revised Moral Appraisal of Early Induction of Labor in Cases of Anencephaly.John Holmes - 2023 - HEC Forum 35 (4):389-406.
    The central concern of this article is whether early induction of labor for an anencephalic fetus can ever be morally justified, particularly by a Catholic healthcare ethics committee. By revisiting and refining arguments in articles by Drane (1992) and Bole (1992) published in this journal, a revised argument – consistent with the Catholic moral tradition – can seemingly be constructed that a Catholic healthcare ethics committee might use to justify early induction of labor in some pregnancies involving an anencephalic fetus. (...)
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  48. Against the Turn to Critical Race Theory and “Anti-racism” in Academic Medicine.Thomas S. Huddle - 2023 - HEC Forum 35 (4):337-356.
    Medical academics are increasingly bringing critical race theory (CRT) or its corollaries to their discourse, to their curricula, and to their analyses of health and medical treatment disparities. The author argues that this is an error. The author considers the history of CRT, its claims, and its current presence in the medical literature. He contends that CRT is inimical to usual academic modes of inquiry and has obscured rather than aided the analysis of social and medical treatment disparities. Remedies for (...)
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  49. Responding Well to Spiritual Worldviews: A Taxonomy for Clinical Ethicists.Trevor M. Bibler - 2023 - HEC Forum 35 (4):309-323.
    Every clinical ethics consultant, no matter their own spirituality, will meet patients, families, and healthcare professionals whose spiritualities anchor their moral worldviews. How might ethicists respond to those who rely on spirituality when making medical decisions? And further, should ethicists incorporate their own spiritual commitments into their clinical analyses and recommendations? These questions prompt reflection on foundational issues in the philosophy of medicine, political and moral theory, and methods of proper clinical ethics consultation. Rather than attempting to offer definitive answers (...)
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  50. A Sceptics Report: Canada’s Five Years Experience with Medical Termination (MAiD). [REVIEW]Tom Koch - 2023 - HEC Forum 35 (4):357-369.
    This article seeks to assess the results of legislation legalizing medical termination, known in Canada as "medical aide in dying" in 2016. Its focus, like that of previous authors, is to ask if the concerns of skeptics opposed to legalization have been realized or were they unfounded. These include the likelihood of a “slippery slope” with an expanding definition of eligibility and of MAiD deaths. Of similar concern at least since 1995 was the likelihood that, in the absence of the (...)
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