Bioethical Concern Research Articles

The provision of abortion in Australia: service delivery as a bioethical concern.

Despite significant progress in the legalization and decriminalization of abortion in Australia over the past decade or more recent research and government reports have made it clear that problems with the provision of services remain. This essay examines such issues and sets forth the view that such issues can and should be seen as (bio)ethical concerns. Whilst conscientious objection-the right to opt-out of provision on the basis of clear ethical reservations-is a legally and morally permissible stance that healthcare professionals can adopt, this does not mean those working in healthcare can simply elect not to be providers absent a clear ethical rationale. Furthermore, simple non-provision would seem to contravene the basic tenants of medical professionalism as well as the oft raised claims of the healthcare professions to put the needs of patients first. Recognizing that much of the progress that has been made over the past three decades can be attributed to the efforts of dedicated healthcare professionals who have dedicated their careers to meeting the profession's collective responsibilities in this area of women's health and reproductive healthcare, this paper frames the matter as a collective ethical lapse on the part of healthcare professionals, the healthcare professions and those involved in the management of healthcare institutions. Whilst also acknowledging that a range of complex factors have led to the present situation, that a variety of steps need to be taken to ensure the proper delivery of services that are comprehensive, and that there has been an absence of critical commentary and analysis of this topic by bioethicists, I conclude that there is a need to (re)assess the provision of abortion in Australia at all levels of service delivery and for the healthcare professions and healthcare professionals to take lead in doing so. That this ought to be done is clearly implied by the healthcare profession's longstanding commitment to prioritizing the needs of patient over their own interests.

Emerging Logistic Challenges, Health Disparities, and Bioethical Concerns in Kidney Xenotransplantation: A Literature Review

Emerging Logistic Challenges, Health Disparities, and Bioethical Concerns in Kidney Xenotransplantation: A Literature Review

Religious Affiliation's Influence on How Veterinary Students and Scientist’s View Bioethical Concerns

Animal welfare advocates and veterinarians are concerned with bioethical issues. The need for high animal production efficiency has been satisfied with the aid of biotechnological production systems. But it's believed that these are jeopardizing welfare and posing moral and ethical dilemmas, especially for vets. In light of the paucity of information on this topic, a survey was conducted to ascertain scientists' and students' opinions regarding animal ethics at the Lala Lajpat Rai University of Veterinary and Animal Sciences in Hisar, Haryana. Random selection was used to select the scientists and students in the sample. The perception—which was defined as a positive or negative tendency toward acceptance of cloning, xenotransplantation, animal rights, stem cell research, and factory farming—was measured using a questionnaire. It was clear from the average response score that respondents' opinions on scientific advancements were unbiased. Researchers found that respondents' average response score indicated a neutral opinion regarding scientific advancements, with scientists being much more accepting than students. Religion does not seem to have a significant influence on perception about bioethical matters. It is further supported by the fact that there is little variation in the respondents' opinions that cultural and traditional values, as well as veterinary education, play a role. It is stated that further research into the factors related to perception is necessary.

Against loneliness we unite: A solidarity-based account of loneliness.

Loneliness is ubiquitous and is bad for our health, making it a bioethical concern. It is perhaps true now more than ever before. Recent publications in bioethics have discussed loneliness in the context of responsibility, solidarity, and autonomy, especially relational autonomy. In this paper, I elaborate on the relation between solidarity and loneliness, proposing an account of loneliness as lack of solidarity. Some cases of loneliness, I argue, may be defined and explained by not having someone to identify with you in some relevant aspect or without someone to assist you. I specifically use the work of George Orwell to make my case.

Empirical Bioethics and the Health ‘Brain-Drain’: a qualitative study of the experiential and ethical landscape of compulsory community service for a group of South African doctors

The health ‘brain drain’ (HBD) is an issue of significant global bioethical concern, resulting in severe maldistribution of healthcare workers (HCWs) and gross inequities in health service provision. The ethics...

Forced Sterilization

Forced Sterilization

Publication ethics of human studies in the light of the Declaration of Helsinki – a mini-review

The Declaration of Helsinki is a set of ethical principles to be followed by scientists involved in medical research with humans or human cells and tissues. This Declaration defines how scientific research should be planned, carried out, documented, analysed, and published.
 We summarise and discuss some ethical issues related to publishing original articles, including clinical trials, review papers, and case reports based on the seventh revision of the Declaration of Helsinki.
 The principles of the Declaration of Helsinki refer most strongly to the publication of medical research results, in particular clinical trials, as original articles. Such papers must meet several ethical requirements, especially the study protocol transparency and the presentation of the results. For case reports, the bioethical aspects related to their publication are twofold - they must include informed and voluntary consent and the confidentiality of study participants. The review papers are of the least bioethical concern. However, whether patients' agreements with specific studies are valid if the data are used in meta-analyses is uncertain.
 Adherence to ethical policies and standards helps to ensure the highest possible quality of scientific publications. Responsibility for compliance with the Declaration of Helsinki lies not only with the authors preparing their manuscripts but also with the editorial board and reviewers, who must evaluate the ethical soundness of the submitted papers. The additional guidelines for the different types of studies facilitate the implementation of the Declaration principles.

Recognizing Racism in US Bioethics as the Subject of Bioethical Concern

Attending to racism and US bioethics raises the question of whether and how racism in bioethics has been the subject of bioethical scrutiny. Bioethics has certainly brought its analytical tools to bear on racist aspects of clinical care and biomedical research. But has bioethics studied racism in bioethics as its subject? A close examination of relevant reports, articles, and books in the US bioethics literature published in the early days of the field, pre-2000, shows mixed findings. In the 1970s, racism as a bioethical concern was variously nonexistent, vaguely implied, and powerfully examined and condemned. In the late 1980s/early to mid-1990s, racism was more frequently described and critiqued, often in the context of discussions about African American perspectives of biomedical ethics and inequities in health care. Understanding how racism in bioethics has been addressed as an ethical concern has consequences for the historical narratives told about the field, for antiracist bioethics work today, and for envisioning an antiracist future for bioethics.

Bioethical and social constructions of life extension and longevity

This paper explores life span extension and longevity as one aspect of life course, focusing on the bioethical and social implications of the rise of longevity in modern societies. We juxtaposed Potter?s categorisation of types of survival with the opposing views about life extension. This ethical and ideological contrast is especially pro?nounced when it comes to human enhancement, which improves human capacities and functioning above and beyond the statistical norm of human health. In the medi?um and long term, these interventions would change not only the human species, but also social roles and relation?ships. The crux of social and bioethical concern could be expressed through the questions: from what age do we start extending human life, and for whom? Does the exten?sion of life lead to the re-establishment of our social roles from youth, or is it just a romantic image of our previous life stage? This study concludes that both paternalistic approaches to life extension and those avoiding modern medical treatments of diseases related to aging are faced with similar epistemological and social reductionism.

Bioethical Concerns During the COVID-19 Pandemic: What Did Healthcare Ethics Committees and Institutions State in Spain?

Objectives: Each new wave of the COVID-19 pandemic invites the possible obligation to prioritize individuals' access to vital resources, and thereby leads to unresolved and important bioethical concerns. Governments have to make decisions to protect access to the health system with equity. The prioritization criteria during a pandemic are both a clinical and legal-administrative decision with ethical repercussion. We aim to analyse the prioritization protocols used in Spain during the pandemic which, in many cases, have not been updated.Method: We carried out a narrative review of 27 protocols of prioritization proposed by healthcare ethics committees, scientific societies and institutions in Spain for this study. The review evaluated shared aspects and unique differences and proffered a bioethical reflection.Results: The research questions explored patient prioritization, the criteria applied and the relative weight assigned to each criterion. There was a need to use several indicators, being morbidity and mortality scales the most commonly used, followed by facets pertaining to disease severity and functional status. Although age was initially considered in some protocols, it cannot be the sole criterion used when assigning care resources.Conclusions: In COVID-19 pandemic there is a need for a unified set of criteria that guarantees equity and transparency in decision-making processes. Establishing treatment indications is not the aim of such criteria, but instead prioritizing access to care resources. In protocols of prioritization, the principle of efficiency must vary according to the principle of equity and the criteria used to guarantee such equity.

Experimental philosophical bioethics and normative inference

This paper explores an emerging sub-field of both empirical bioethics and experimental philosophy, which has been called “experimental philosophical bioethics” (bioxphi). As an empirical discipline, bioxphi adopts the methods of experimental moral psychology and cognitive science; it does so to make sense of the eliciting factors and underlying cognitive processes that shape people’s moral judgments, particularly about real-world matters of bioethical concern. Yet, as a normative discipline situated within the broader field of bioethics, it also aims to contribute to substantive ethical questions about what should be done in a given context. What are some of the ways in which this aim has been pursued? In this paper, we employ a case study approach to examine and critically evaluate four strategies from the recent literature by which scholars in bioxphi have leveraged empirical data in the service of normative arguments.

The Use of Sonography in Pediatrics: The Bioethical Concerns in Clinical and Research Practice

Sonography has been widely used in both a clinical and non-clinical setting. This imaging modality is a common tool of choice for both physicians and researchers. Although sonography is a non-ionizing and non-invasive tool for imaging, special considerations need to be made when working with the pediatric population. Ethical guidelines for clinical pediatric care and research need to consider the varying ethical guidelines and bioethical concerns in children. As sonographers, researchers, educators and clinicians, pediatric care and research must balance the protection of children and the need for imaging to improve pediatric well-being. The discussion of this paper will delve into The Principles Approach developed by Beauchamp and Childress. Each principle will be explored and how those ethical principles could be considered in pediatric care.

There’s No Harm in Talking: Re-Establishing the Relationship Between Theological and Secular Bioethics

Theological and secular voices in bioethics have drifted into separate silos. Such a separation results in part from (1) theologians focusing less on conveying ideas in ways that contribute to a pluralistic and public bioethical discourse and (2) the dwindling receptivity of religious arguments within secular bioethics. This essay works against these drifts by putting forward an argument that does not bounce around a religious echo-chamber, but instead demonstrates how insights of Christian anthropology can be meaningfully responsive to secular bioethics’ rightful concerns with inequality and injustice. We offer core concepts from Christian bioethics that encourage dialogue with secular and theological bioethicists. The theologically-grounded concepts, human dignity, sin, and the common good, provide intellectual resources to address major areas of bioethical concern that remain unresolved.

Non-Medical Sex Selection in Australia: Public Views and Bioethical Concerns

In 2017, following an extensive review of its ethical guidelines on assisted reproductive technology (ART), the Australian National Health and Medical Research Council (NHMRC) upheld its moratorium on non-medical sex selection (NMSS) pending further public debate. Interestingly, the public consultation conducted by the NHMRC revealed a majority of submissions supported a permissive approach to NMSS, suggesting a potential shift in attitudes about NMSS in Australia. Historically, public consultation on NMSS both internationally and in Australia has revealed general opposition to this practice. This has reinforced concerns raised against NMSS in bioethical debates and been reflected in a restrictive regulatory approach to NMSS in many countries. The NHMRC public consultation highlights a potential disconnect between the concerns raised about NMSS in scholarly literature and more liberal community views. This paper reviews the submissions made to the NHMRC on NMSS and argues that the current moratorium should be revisited with a view to exploring a more nuanced approach to regulating NMSS in the future.

The Medical Futility Experience of Nurses in Caring for Critically Ill Patients.

Medical futility is a key bioethical concern. In Taiwan, policymakers tend to provide care standards and evaluation guidelines for critically ill and terminal patients whose treatment is medically futile. However, the current status of medical futility for critically ill patients is inadequate, and no consensus currently exists on the definition of medical futility. The aim of this study was to understand the medical futility experiences of intensive care nurses. This qualitative research adopted a phenomenological perspective and was conducted in a medical center and a regional hospital in Central Taiwan. Eight nurses with at least 1 year of nursing tenure who were serving in the intensive care unit were recruited. Purposive and snowball sampling methods were used to conduct one-on-one in-depth interviews. Each of the tape-recorded interviews was transcribed before data analysis. The research results found four themes, including (a) definitions of medical futility and types of patients, (b) considerations of medical futility, (c) the occurrence of medical futility, and (d) nurses' responses to medical futility. The participants indicated that medical futility refers to the point at which the continued provision of treatment does not evidently ease the disease condition of a patient or improve his or her quality of life or when life-sustaining treatment is provided to patients to facilitate the process of death. This study revealed that the major challenge in clinical cases of medical futility is for physicians, nurses, and patients to communicate effectively together during times of rapid and unanticipated change in patient condition. Thus, events of medical futility may be preventable. Past cases of medical futility involving critically ill patients may serve as references for guiding clinical care, education, and related policy formulation.

¿Bioética narrativa o narrativa bioética?

<p><span>Desde los inicios de la bioética, se presenta y agudiza el conflicto entre biomedicina científica basada en evidencia, y la bioética preocupada de valores personales y participativos que la medicina terapéutica y la investigación biomédica han de respetar en la participación autónoma de pacientes y probandos. El proceso de consentimiento informado debiera desplegar la narrativa de los valores existenciales de cada persona y el contexto social en que vive. La bioética narrativa y las humanidades médicas son convocadas para sensibilizar a los profesionales de la salud en esas tareas. Su influencia por elevar los elementos narrativos en la comunicación biomédica ha sido insuficiente y decreciente, no logrado evitar un academicismo extremo y una irrelevancia social de la disciplina bioética que está en riesgo de ser marginada, desoída y precipitada en una crisis de validación.</span></p><p><span>Sugiere este artículo atender a fuentes no académicas que se muestran plenamente competentes y atractivas para encarar los problemas que la bioética no ha sabido resolver, destacando la publicación de novelas ficcionales que abordan relatos de temas bioéticos en forma amena y sistemática, que impactan más allá de las deliberaciones anémicas de la bioética:<span class="apple-converted-space"> </span><em> The Children Act</em>, (I. McKewan, 2014) y<span class="apple-converted-space"> </span><em>Reparar a los vivos</em><span class="apple-converted-space"> </span>(M. de Kerangal, M., 2015), son presentadas como propuesta para inaugurar la narrativa bioética, que es el relato ficcional de temas bioéticos.</span></p>

Pope Francis and Bioethical Concerns in Amoris laetitia

Amoris laetitia (The Joy of Love), Pope Francis’s apostolic exhortation on love in the family, provides the pontiff’s reflections following the 2014–2015 Synods of Bishops on the Family. In it, he examines the situation of families in today’s world and calls readers’ attention “to the parts dealing with their specific needs.” The Pope anchors Amoris laetitia in the continuity of Church teaching, supporting his observations with various documents from the magisterium, including Humanae vitae, Gaudium et spes, Familiaris consortio, and the Catechism of the Catholic Church.

Learning From Philadelphia: Topographies of HIV/AIDS Media Assemblages

ABSTRACTFor this contribution to the special issue on “Mapping Queer Bioethics,” the author employs an array of public health and popular media texts (especially Jonathan Demme’s film Philadelphia) to challenge the construction and reconstruction of HIV-positive bodies as sites of bioethical concern. In outlining notions of “digital restoration,” the author argues that there has been of late a remapping of the first decade of the HIV/AIDS pandemic through media projects assembled from archived materials. Accordingly, the author suggests that in the first decades of the 2000s, we have witnessed a media-archaeological turn, whereby old materials have been reassembled for commemorative purposes that oftentimes perform a reshaping of the topography of the first decade of the AIDS pandemic.

Rethinking the therapeutic misconception: social justice, patient advocacy, and cancer clinical trial recruitment in the US safety net.

BackgroundApproximately 20% of adult cancer patients are eligible to participate in a clinical trial, but only 2.5-9% do so. Accrual is even less for minority and medically underserved populations. As a result, critical life-saving treatments and quality of life services developed from research studies may not address their needs. This study questions the utility of the bioethical concern with therapeutic misconception (TM), a misconception that occurs when research subjects fail to distinguish between clinical research and ordinary treatment, and therefore attribute therapeutic intent to research procedures in the safety net setting. This paper provides ethnographic insight into the ways in which research is discussed and related to standard treatment.MethodsIn the course of two years of ethnographic fieldwork in a safety net hospital, I conducted clinic observations (n = 150 clinic days) and in-depth in-person qualitative interviews with patients (n = 37) and providers (n = 15). I used standard qualitative methods to organize and code resulting fieldnote and interview data.ResultsFindings suggest that TM is limited in relevance for the interdisciplinary context of cancer clinical trial recruitment in the safety net setting. Ethnographic data show the value of the discussions that happen prior to the informed consent, those that introduce the idea of participation in research. These preliminary discussions are elemental especially when recruiting underserved and vulnerable patients for clinical trial participation who are often unfamiliar with medical research and how it relates to medical care. Data also highlight the multiple actors involved in research discussions and the ethics of social justice and patient advocacy they mobilize, suggesting that class, inequality, and dependency influence the forms of ethical engagements in public hospital settings.ConclusionOn the ground ethics of social justice and patient advocacy are more relevant than TM as guiding ethical principles in the context of ongoing cancer disparities and efforts to diversify clinical trial participation.

Diagnosis and treatment for vulvar cancer for indigenous women from East Arnhem Land, Northern Territory: bioethical reflections.

This paper explores the bioethical issues associated with the diagnosis and treatment of vulvar cancer for Indigenous women in East Arnhem Land, Northern Territory, Australia. Based on a qualitative study of a vulvar cancer cluster of Indigenous women, the article highlights four main topics of bioethical concern drawn from the findings: informed consent, removal of body parts, pain management, and issues at the interface of Indigenous and Western health care. The article seeks to make a contribution towards Indigenous health and bioethics and bring to light areas of further research.