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  1. Applying the Precautionary Principle to Pandemics.Jonathan Birch - manuscript
    When faced with an urgent and credible threat of grave harm, we should take proportionate precautions. This maxim captures the core commitments of the “precautionary principle”. But what is it for a precaution to be “proportionate”? I construct an account of proportionality (the “ARCANE” account) that consists of five fundamental conditions (absolute rights compatibility, reasonable compensation, consistency, adequacy and non- excessiveness) and a tie-breaker (efficiency). I apply this account to two examples from the COVID-19 pandemic (border closures and school closures), (...)
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  2. The debate on the ethics of AI in health care: a reconstruction and critical review.Jessica Morley, Caio C. V. Machado, Christopher Burr, Josh Cowls, Indra Joshi, Mariarosaria Taddeo & Luciano Floridi - manuscript
    Healthcare systems across the globe are struggling with increasing costs and worsening outcomes. This presents those responsible for overseeing healthcare with a challenge. Increasingly, policymakers, politicians, clinical entrepreneurs and computer and data scientists argue that a key part of the solution will be ‘Artificial Intelligence’ (AI) – particularly Machine Learning (ML). This argument stems not from the belief that all healthcare needs will soon be taken care of by “robot doctors.” Instead, it is an argument that rests on the classic (...)
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  3. Preventing Human Rights Violations in Prison – the Role of Guidelines.Bernice Elger & David Shaw - forthcoming - In Bernice Elger, Catherine Ritter & Heino Stöver (eds.), Emerging Issues in Prison Health. Springer.
    It is well known that prisoners’ human rights are often violated. In this chapter we examine whether guidelines can be effective in preventing such violations and in helping physicians resolve the significant conflicts of interest that they often face in trying to protect prisoners’ rights. We begin by explaining the role of clinical and ethical guidelines outside prisons, in the context of healthcare for non-incarcerated prisoners, and then the specific role of such guidelines within prisons, where the main concerns are (...)
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  4. Ethics consultation in US hospitals: A national survey.Ellen Fox, Sarah Myers & Robert A. Pearlman - forthcoming - Bioethics.
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  5. F23. Shinshu University Hospital Established the Division of Clinical Genetics as One of its Central Service Departments.Yoshimitsu Fukushima - forthcoming - Bioethics in Asia: The Proceedings of the Unesco Asian Bioethics Conference (Abc'97) and the Who-Assisted Satellite Symposium on Medical Genetics Services, 3-8 Nov, 1997 in Kobe/Fukui, Japan, 3rd Murs Japan International Symposium, 2nd Congress of the Asi.
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  6. The role and legal status of health care ethics committees in the United States.Diane Hoffmann & Anita Tarzian - forthcoming - Legal Perspectives in Bioethics: Annals of Bioethics Series, Ana S. Iltis, Sandra H. Johnson, Barbara A. Hinze, Eds.
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  7. Clarifying Capacity: Reasons and Value.Jules Holroyd - forthcoming - In Lubomira Radoilska (ed.), Autonomy and Mental Health. Oxford University Press.
    It is usually appropriate for adults to make significant decisions, such as about what kinds of medical treatment to undergo, for themselves. But sometimes impairments are suffered - either temporary or permanent - which render an individual unable to make such decisions. The Mental Capacity Act 2005 sets out the conditions under which it is appropriate to regard an individual as lacking the capacity to make a particular decision (and when provisions should be made for a decision on their behalf). (...)
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  8. Congressional investigating committees.Alfred Junz - forthcoming - Social Research: An International Quarterly.
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  9. The Ethical Significance of Post-Vaccination COVID-19 Transmission Dynamics.Steven R. Kraaijeveld - forthcoming - Journal of Bioethical Inquiry:1-9.
    The potential for vaccines to prevent the spread of infectious diseases is crucial for vaccination policy and ethics. In this paper, I discuss recent evidence that the current COVID-19 vaccines have only a modest and short-lived effect on reducing SARS-CoV-2 transmission and argue that this has at least four important ethical implications. First, getting vaccinated against COVID-19 should be seen primarily as a self-protective choice for individuals. Second, moral condemnation of unvaccinated people for causing direct harm to others is unjustified. (...)
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  10. In Practice: At the Lok Nayak Hospital, Delhi.John D. Lantos - forthcoming - Hastings Center Report.
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  11. Behind Closed Doors: Promises and Pitfalls of Ethics Committees.Bernard Lo - forthcoming - Bioethics.
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  12. Unexpected Complications of Novel Deep Brain Stimulation Treatments: Ethical Issues and Clinical Recommendations.Hannah Maslen, Binith Cheeran, Jonathan Pugh, Laurie Pycroft, Sandra Boccard, Simon Prangnell, Alexander Green, James FitzGerald, Julian Savulescu & Tipu Aziz - forthcoming - Neuromodulation.
    Background -/- Innovative neurosurgical treatments present a number of known risks, the natures and probabilities of which can be adequately communicated to patients via the standard procedures governing obtaining informed consent. However, due to their novelty, these treatments also come with unknown risks, which require an augmented approach to obtaining informed consent. -/- Objective -/- This paper aims to discuss and provide concrete procedural guidance on the ethical issues raised by serious unexpected complications of novel deep brain stimulation treatments. -/- (...)
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  13. Hospital Ethics Committees In: Connor SS, Fuenzilida–Puelma HL, eds.J. C. Tealdi & J. A. Mainetti - forthcoming - Bioethics: Issues and Perspectives. Washington Dc: Paho.
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  14. An Ethical Framework for Hospital Ethics Committees.Robert M. Veatch - forthcoming - Contemporary Issues in Bioethics, Third Edition (Wadsworth Publishing Company, Belmont, California).
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  15. Institutional ethics committees.W. A. W. Walters - forthcoming - Unpublished Paper Presented at Bioethics Course, Monash University Centre for Human Bioethics, Warburton Vic.
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  16. Posthuman to Inhuman: mHealth Technologies and the Digital Health Assemblage.Jack Black & Jim Cherrington - 2022 - Theory and Event 25 (4):726--750.
    In exploring the intra-active, relational and material connections between humans and non- humans, proponents of posthumanism advocate a questioning of the ‘human’ beyond its traditional anthropocentric conceptualization. By referring specifically to controversial developments in mHealth applications, this paper critically diverges from posthuman accounts of human/non-human assemblages. Indeed, we argue that, rather than ‘dissolving’ the human subject, the power of assemblages lie in their capacity to highlight the antagonisms and contradictions that inherently affirm the importance of the subject. In outlining this (...)
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  17. Bio-ethics and one health: a case study approach to building reflexive governance.Antoine Boudreau LeBlanc, Bryn Williams-Jones & Cécile Aenishaenslin - 2022 - Frontiers in Public Health 10 (648593).
    Surveillance programs supporting the management of One Health issues such as antibiotic resistance are complex systems in themselves. Designing ethical surveillance systems is thus a complex task (retroactive and iterative), yet one that is also complicated to implement and evaluate (e.g., sharing, collaboration, and governance). The governance of health surveillance requires attention to ethical concerns about data and knowledge (e.g., performance, trust, accountability, and transparency) and empowerment ethics, also referred to as a form of responsible self-governance. Ethics in reflexive governance (...)
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  18. We Should Not Use Randomization Procedures to Allocate Scarce Life-Saving Resources.Roberto Fumagalli - 2022 - Public Health Ethics 15 (1):87-103.
    In the recent literature across philosophy, medicine and public health policy, many influential arguments have been put forward to support the use of randomization procedures to allocate scarce life-saving resources. In this paper, I provide a systematic categorization and a critical evaluation of these arguments. I shall argue that those arguments justify using RAND to allocate SLSR in fewer cases than their proponents maintain and that the relevant decision-makers should typically allocate SLSR directly to the individuals with the strongest claims (...)
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  19. Justifying the risks of COVID-19 challenge trials: The analogy with organ donation.Athmeya Jayaram, Jacob Sparks & Daniel Callies - 2022 - Bioethics 36 (1):100-106.
    In the beginning of the COVID pandemic, researchers and bioethicists called for human challenge trials to hasten the development of a vaccine for COVID. However, the fact that we lacked a specific, highly effective treatment for COVID led many to argue that a COVID challenge trial would be unethical and we ought to pursue traditional phase III testing instead. These ethical objections to challenge trials may have slowed the progress of a COVID vaccine, so it is important to evaluate their (...)
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  20. “First, Do No Harm”?Stephen John & Joseph Wu - 2022 - Social Theory and Practice 48 (3):525-551.
    Screening for asymptomatic disease is a routine aspect of contemporary public health practice. However, it is also controversial, because it leads to overdiagnosis and overtreatment, with many arguing that programmes are “ineffective,” i.e., the “costs” outweigh the “benefits.” This paper explores a more fundamental objection to screening programmes: that, even if they are effective, they are ethically impermissible because they breach the principle of non-maleficence. In so doing, it suggests a new approach to the ethics of risk, justifying a concern (...)
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  21. Social, Technological and Health Innovation: Opportunities and Limitations for Social Policy, Health Policy, and Environmental Policy.Andrzej Klimczuk, Magdalena Klimczuk-Kochańska & Jorge Felix (eds.) - 2022 - Lausanne: Frontiers Media.
    This Research Topic focuses on both strengths and weaknesses of social innovation, technological innovation, and health innovation that are increasingly recognized as crucial concepts related to the formulation of responses to the social, health, and environmental challenges. Goals of this Research Topic: (1) to identify and share the best recent practices and innovations related to social, environmental and health policies; (2) to debate on relevant governance modes, management tools as well as evaluation and impact assessment techniques; (3) to discuss dilemmas (...)
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  22. Against COVID‐19 vaccination of healthy children.Steven R. Kraaijeveld, Rachel Gur-Arie & Euzebiusz Jamrozik - 2022 - Bioethics 36 (6):687-698.
  23. Altruistic Vaccination: Insights from Two Focus Group Studies.Steven R. Kraaijeveld & Bob C. Mulder - 2022 - Health Care Analysis 30 (3):275-295.
    Vaccination can protect vaccinated individuals and often also prevent them from spreading disease to other people. This opens up the possibility of getting vaccinated for the sake of others. In fact, altruistic vaccination has recently been conceptualized as a kind of vaccination that is undertaken primary for the benefit of others. In order to better understand the potential role of altruistic motives in people’s vaccination decisions, we conducted two focus group studies with a total of 37 participants. Study 1 included (...)
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  24. Etica della comunicazione sanitaria.Elisabetta Lalumera - 2022 - Bologna BO, Italia: Mulino.
    Una sintetica introduzione alle principali questioni etiche e filosofiche riguardanti la comunicazione sanitaria: la comunicazione fra medico e paziente e quella fra istituzioni, sanitari e cittadini. In uno scenario in cui autonomia e consenso della persona sono sempre più rilevanti nelle scelte di cura e di tutela della salute, l’autrice delinea un quadro concettuale aggiornato per affrontare temi problematici come la comunicazione della diagnosi, l’impostazione delle campagne di prevenzione e salute pubblica, il ruolo dei medici come esperti nei media. -/- (...)
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  25. Differential impact of opt-in, opt-out policies on deceased organ donation rates: a mixed conceptual and empirical study.Alberto Molina-Pérez, David Rodríguez-Arias & Janet Delgado - 2022 - BMJ Open 12:e057107.
    Objectives To increase postmortem organ donation rates, several countries are adopting an opt-out (presumed consent) policy, meaning that individuals are deemed donors unless they expressly refused so. Although opt-out countries tend to have higher donation rates, there is no conclusive evidence that this is caused by the policy itself. The main objective of this study is to better assess the direct impact of consent policy defaults per se on deceased organ recovery rates when considering the role of the family in (...)
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  26. COVID-19 Vaccine Refusal and Fair Allocation of Scarce Medical Resources.Govind Persad & Emily A. Largent - 2022 - JAMA Health Forum 3 (4):e220356.
    When hospitals face surges of patients with COVID-19, fair allocation of scarce medical resources remains a challenge. Scarcity has at times encompassed not only hospital and intensive care unit beds—often reflecting staffing shortages—but also therapies and intensive treatments. Safe, highly effective COVID-19 vaccines have been free and widely available since mid-2021, yet many Americans remain unvaccinated by choice. Should their decision to forgo vaccination be considered when allocating scarce resources? Some have suggested it should, while others disagree. We offer a (...)
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  27. Why we should stop using animal-derived products on patients without their consent.Daniel Rodger - 2022 - Journal of Medical Ethics 48 (10):702-706.
    Medicines and medical devices containing animal-derived ingredients are frequently used on patients without their informed consent, despite a significant proportion of patients wanting to know if an animal-derived product is going to be used in their care. Here, I outline three arguments for why this practice is wrong. First, I argue that using animal-derived medical products on patients without their informed consent undermines respect for their autonomy. Second, it risks causing nontrivial psychological harm. Third, it is morally inconsistent to respect (...)
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  28. Attitudes Toward Mandatory COVID-19 Vaccination in Germany A representative analysis of data from the socio-economic panel for the year 2021.Christoph Schmidt-Petri, Carsten Schröder & Thomas Rieger - 2022 - Deutsches Ärzteblatt International 119:335-41.
    Background: Adequate immunity to COVID-19 apparently cannot be attained in Germany by voluntary vaccination alone, and therefore the introduction of mandatory COVID-19 vaccination is still under consideration. We present findings on the potential acceptance of such a requirement by the German population, and we report on the reasons given for accepting or rejecting it and how these reasons vary according to population subgroup. -/- Methods: We used representative data from the Socio-Economic Panel for the period January to December 2021. We (...)
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  29. Climate Change, Pollution, Deforestation, and Mental Health: Research Trends, Gaps, and Ethical Considerations.Moritz E. Wigand, Cristian Timmermann, Ansgar Scherp, Thomas Becker & Florian Steger - 2022 - GeoHealth 6 (11):e2022GH000632.
    Climate change, pollution, and deforestation have a negative impact on global mental health. There is an environmental justice dimension to this challenge as wealthy people and high-income countries are major contributors to climate change and pollution, while poor people and low-income countries are heavily affected by the consequences. Using state-of-the art data mining, we analyzed and visualized the global research landscape on mental health, climate change, pollution and deforestation over a 15-year period. Metadata of papers were exported from PubMed®, and (...)
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  30. COVID-19 as the underlying cause of death: disentangling facts and values.Maria Cristina Amoretti & Elisabetta Lalumera - 2021 - History and Philosophy of the Life Sciences 43 (1):1-4.
    In the ongoing pandemic, death statistics influence people’s feelings and government policy. But when does COVID-19 qualify as the cause of death? As philosophers of medicine interested in conceptual clarification, we address the question by analyzing the World Health Organization’s rules for the certification of death. We show that for COVID-19, WHO rules take into account both facts and values.
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  31. What is Public Health?Jonathan Anomaly - 2021 - Public Choice 188.
  32. E-cigarettes: The Long-Term Liberal Perspective.Kalle Grill - 2021 - Nicotine and Tobacco Research 23 (1):9-13.
    The debate for and against making e-cigarettes available to smokers is to a large extent empirical. We do not know the long-term health effects of vaping and we do not know how smokers will respond to e-cigarettes over time. In addition to these empirical uncertainties, however, there are difficult moral issues to consider. One such issue is that many smokers in some sense choose to smoke. Though smoking is addictive and though many start young, it does not seem impossible to (...)
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  33. Addressing organ shortage: An automatic organ procurement model as a proposal.Marina Morla-González, Clara Moya-Guillem, David Rodríguez-Arias, Íñigo de Miguel Beriain, Alberto Molina-Pérez & Iván Ortega-Deballon - 2021 - Clinical Ethics 16 (4):278-290.
    Organ shortage constitutes an unsolved problem for every country that offers transplantation as a therapeutic option. Besides the largely implemented donation model and the eventually implemented market model, a theorized automatic organ procurement model has raised a rich debate in the legal, medical and bioethical community, since it could show a higher potential to solve organ shortage. In this paper, we study the main arguments for and against this model. We show how, in the light of empirical data extracted from (...)
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  34. Against Draconian Penalties for Covid-19 Quarantine Infringements.Elias Moser - 2021 - Etikk I Praksis - Nordic Journal of Applied Ethics 2:17-28.
    In 2020, after the first Covid-19 lockdown, several countries implemented a policy of contact tracing and self-isolating for individuals who crossed borders or came into contact with infected people. To enforce these restrictions, some states imposed very harsh monetary penalties for people who violated them. Behind these harsh fines lies an instrumental rationale. They allow the state to avoid implementing a system of labor-intensive and costly surveillance and enforcement. In this article I argue that such severe penalties are extremely unjust. (...)
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  35. Improving the Ethical Review of Health Policy and Systems Research: Some Suggestions.Govind Persad - 2021 - Journal of Law, Medicine and Ethics 49 (1):123-125.
    Consistent and well-designed frameworks for ethical oversight enable socially valuable research while forestalling harmful or poorly designed studies. I suggest some alterations that might strengthen the valuable checklist Rattani & Hyder propose for the ethical review of health policy and systems research (HPSR), or prompt future work in the area.
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  36. Tailoring public health policies.Govind Persad - 2021 - American Journal of Law and Medicine 47 (2-3):176–204.
    In an effort to contain the spread of COVID-19, many states and countries have adopted public health restrictions on activities previously considered commonplace: crossing state borders, eating indoors, gathering together, and even leaving one’s home. These policies often focus on specific activities or groups, rather than imposing the same limits across the board. In this Article, I consider the law and ethics of these policies, which I call tailored policies. In Part II, I identify two types of tailored policies--activity-based and (...)
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  37. Ethical considerations of offering benefits to COVID-19 vaccine recipients.Govind Persad & Ezekiel J. Emanuel - 2021 - JAMA 326 (3):221-222.
    We argue that the ethical case for instituting vaccine benefit programs is justified by 2 widely recognized values: (1) reducing overall harm from COVID-19 and (2) protecting disadvantaged individuals. We then explain why they do not coerce, exploit, wrongfully distort decision-making, corrupt vaccination's moral significance, wrong those who have already been vaccinated, or destroy willingness to become vaccinated. However, their cost impacts and their effects on public perception of vaccines should be evaluated.
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  38. Pushing poverty off limits: quality improvement and the architecture of healthcare values.Guddi Singh, Vikki Entwistle, Alan Cribb & Polly Mitchell - 2021 - BMC Medical Ethics 22 (1):1-13.
    Background: Poverty and social deprivation have adverse effects on health outcomes and place a significant burden on healthcare systems. There are some actions that can be taken to tackle them from within healthcare institutions, but clinicians who seek to make frontline services more responsive to the social determinants of health and the social context of people’s lives can face a range of ethical challenges. We summarise and consider a case in which clinicians introduced a poverty screening initiative into paediatric practice (...)
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  39. Opioid Treatment Agreements and Patient Accountability.Larisa Svirsky - 2021 - Hastings Center Report 51 (4):46-9.
    Opioid treatment agreements are written agreements between physicians and patients enumerating the risks associated with opioid medications along with the requirements that patients must meet to receive these medications on an ongoing basis. The choice to use such agreements goes beyond the standard informed consent process, and has a distinctive symbolic significance. Specifically, it suggests that physicians regard it as important to hold their patients accountable for adhering to various protocols regarding the use of their opioid medications. After laying out (...)
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  40. Three Ways in Which Pandemic Models May Perform a Pandemic.Philippe Van Basshuysen, Lucie White, Donal Khosrowi & Mathias Frisch - 2021 - Erasmus Journal for Philosophy and Economics 14 (1):110-127.
    Models not only represent but may also influence their targets in important ways. While models’ abilities to influence outcomes has been studied in the context of economic models, often under the label ‘performativity’, we argue that this phenomenon also pertains to epidemiological models, such as those used for forecasting the trajectory of the Covid-19 pandemic. After identifying three ways in which a model by the Covid-19 Response Team at Imperial College London may have influenced scientific advice, policy, and individual responses, (...)
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  41. The Innocent Mosquito? The environmental ethics of mosquito eradication.Anna Wienhues - 2021 - In Marcus Hall & Dan Tamïr (eds.), Mosquitopia: The Place of Pests in a Healthy World. London, Vereinigtes Königreich: pp. 195-209.
  42. The Primacy of Duty and Its Efficacy in Combating COVID-19.Robert Elliott Allinson - 2020 - Public Health Ethics 13 (2):179-189.
    Nyansa nye sika na w'akyekyere asie. One critical factor that has contributed to the spread of the virus COVID-19 and resulting illnesses and deaths is both the conceptual and the ethical confusion between the prioritization of individual rights over social duties. The adherence to the belief in the priority of rights over duties has motivated some individuals to refrain from social distancing and, as a result, has placed themselves and other individuals at serious risk to health and life. My argument (...)
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  43. Stephen Snelders. Leprosy and Colonialism: Suriname under Dutch Rule, 1750–1950. ix + 276 pp., notes, figs., tables, bibl., index. Manchester: Manchester University Press, 2017. £75 (cloth); ISBN 9781526112996. E-book available. [REVIEW]Nandini Bhattacharya - 2020 - Isis 111 (4):887-888.
  44. Digital psychiatry: ethical risks and opportunities for public health and well-being.Christopher Burr, Jessica Morley, Mariarosaria Taddeo & Luciano Floridi - 2020 - IEEE Transactions on Technology and Society 1 (1):21–33.
    Common mental health disorders are rising globally, creating a strain on public healthcare systems. This has led to a renewed interest in the role that digital technologies may have for improving mental health outcomes. One result of this interest is the development and use of artificial intelligence for assessing, diagnosing, and treating mental health issues, which we refer to as ‘digital psychiatry’. This article focuses on the increasing use of digital psychiatry outside of clinical settings, in the following sectors: education, (...)
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  45. Do a Surrogate Decision-Maker's Motives Matter?Michael J. Deem & Jennifer M. Stephen - 2020 - Nursing 50 (2):16-18.
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  46. Public Health and Precarity.Michael D. Doan & Ami Harbin - 2020 - International Journal of Feminist Approaches to Bioethics 13 (2):108-130.
    One branch of bioethics assumes that mainly agents of the state are responsible for public health. Following Susan Sherwin’s relational ethics, we suggest moving away from a “state-centered” approach toward a more thoroughly relational approach. Indeed, certain agents must be reconstituted in and through shifting relations with others, complicating discussions of responsibility for public health. Drawing on two case studies—the health politics and activism of the Black Panther Party and the work of the Common Ground Collective in post-Katrina New Orleans—we (...)
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  47. Responsibility-Sensitive Healthcare Funding: Three Responses to Clavien and Hurst’s Critique.Thomas Douglas - 2020 - Cambridge Quarterly of Healthcare Ethics 2 (29):192-195.
    Christine Clavien and Samia Hurst (henceforth C-H) make at least three valuable contributions to the literature on responsibility and healthcare. They offer an admirably clear and workable set of criteria for determining a patient's degree of responsibility for her health condition; they deploy those criteria to cast doubt on the view that patients with lifestyle-related conditions are typically significantly responsible for their conditions; and they outline several practical difficulties that would be raised by any attempt to introduce responsibility-sensitive healthcare funding. (...)
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  48. Compulsory medical intervention versus external constraint in pandemic control.Thomas Douglas, Lisa Forsberg & Jonathan Pugh - 2020 - Journal of Medical Ethics 47 (12).
    Would compulsory treatment or vaccination for Covid-19 be justified? In England, there would be significant legal barriers to it. However, we offer a conditional ethical argument in favour of allowing compulsory treatment and vaccination, drawing on an ethical comparison with external constraints—such as quarantine, isolation and ‘lockdown’—that have already been authorised to control the pandemic. We argue that, if the permissive English approach to external constraints for Covid-19 has been justified, then there is a case for a similarly permissive approach (...)
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  49. Public relations strategies to counter fake news about vaccines.Gheorghe-Ilie Farte - 2020 - Cahiers de Psychologie Politique 37.
    Comme tous les autres projets humains, les politiques de santé publique sont souvent affectées par des imperfections et des erreurs. Cependant, elles sont mieux ancrées dans les résultats de la recherche scientifique que d’autres actions humaines en général, et politiques gouvernementales en particulier. D’une manière générale, les données sur lesquelles reposent les politiques de santé publique remplissent les conditions suivantes : méthodes de recherche rigoureuses, tests indépendants et précis, reproductibilité des résultats, mesure du taux d’erreur, capacité à écarter des hypothèses (...)
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  50. Amir A. Afkhami. A Modern Contagion: Imperialism and Public Health in Iran’s Age of Cholera. xv + 276 pp., apps., notes, bibl., index. Baltimore: Johns Hopkins University Press, 2019. $54.95 (cloth); ISBN 9781421427218. E-book available. [REVIEW]Richard C. Keller - 2020 - Isis 111 (4):891-892.
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