Duty Of Easy Rescue Research Articles

Coercive public health policies need context-specific ethical justifications.

Public health policies designed to improve individual and population health may involve coercion. These coercive policies require ethical justification, and yet it is unclear in the public health ethics literature which ethical concepts might justify coercion, and what their limitations are in applying across contexts. In this paper, we analyse a number of concepts from Western bioethics, including the harm principle, paternalism, the public interest, and a duty of easy rescue. We find them plausible justifications for coercion in theory, but when applied to case studies, including HIV testing in Malawi, vaccine mandates in South Africa, and prohibitions of antibiotic use in livestock in the EU, their limitations become clear. We argue that the context-specificity of ethical justifications for coercion has been overlooked, and there is more work needed to identify context-relevant ethical justifications for coercive policies in various settings and for various populations, rather than relying on universalising Western bioethical justifications across all contexts.

Developing an Ethical Evaluation Framework for Coercive Antimicrobial Stewardship Policies.

Antimicrobial resistance (AMR) has been declared one of the top ten global public health threats facing humanity. To address AMR, coercive antimicrobial stewardship policies are being enacted in some settings. These policies, like all in public health, require ethical justification. Here, I introduce a framework for ethically evaluating coercive antimicrobial stewardship policies on the basis of ethical justifications (and their limitations). I consider arguments from effectiveness; duty of easy rescue; tragedy of the commons; responsibility-tracking; the harm principle; paternalism; justice and development; a precautionary approach; and professional duties. I consider how these justifications might form the basis for developing a comprehensive ethical framework, and the need for this to be context-specific and aligned with the priorities, evidence and needs of the particular jurisdictions in which a policy is to be enacted. I demonstrate how the ethical justifications might be used by reference to an example policy of the EU ban on the use of certain human-critical antibiotics for livestock, before concluding with challenges for further development of the framework.

O-219 Surplus Frozen Eggs Lay to Waste Opportunities for Research and Treatment

Abstract Study question Is there a moral duty to donate surplus frozen eggs (SFEs)? Summary answer SFEs are a valuable resource with the potential to mitigate harm and improve well-being and should be donated where the costs to donors are small. What is known already In Victoria, Australia, eggs can be stored for up to 10 years, after which SFEs must be discarded, donated to research or to others. Our research shows that many people do not return to use their frozen eggs, many are left in storage and most SFEs are then discarded. At the same time, there is a serious shortage of donated gametes and a high demand for eggs for both research and reproductive treatments. The recent legalisation of mitochondrial donation in Australia has added to the demand for eggs for training, research, and clinical purposes. Study design, size, duration This paper considers whether donation of SFEs can be grounded on ‘the duty of easy rescue’, broadly defined as a moral duty to help others when the harm that might be averted is sufficiently great, and the costs are sufficiently small. Participants/materials, setting, methods We present an ethical analysis of the harms that could be mitigated by egg donation and the costs to donors associated with donation to both research and to others. Main results and the role of chance The harms associated with prolonged infertility, long waiting lists for donor eggs, and gamete donation in less regulated settings are well known. In addition, the use of donated eggs for mitochondrial replacement offers the possibility of avoiding the transmission of serious disease. Our research shows that many SFEs are abandoned or discarded but little is known about why people discard SFEs. Among the ‘costs’ to donors, there are logistical barriers such as the time needed, and the physical and emotional demands associated with donor eligibility screening. There may be additional emotional and ethical costs associated with donation to others; concerns about donor anonymity, the parental status of donors, and the meaning of genetic relationships have been cited as barriers to embryo donation and may also factor in egg donation. We suggest that while donation of SFEs to others may have costs, there are opportunities to facilitate this option, such as offering donor screening at the time of egg freezing, providing education about the current demand for SFEs, and greater discussion and critical reflection about the moral status of donors. We reason that donating to research does not incur the same ‘costs’ and in most cases, represents an ‘easy rescue’. Limitations, reasons for caution This analysis considers ‘costs’ to donors and ‘harms’ relating to the shortfall of donor eggs. However, donors and recipients are not the only actors involved in egg donation. There may be other morally relevant considerations, such as the experience of donor-conceived people, that complicate assessments of costs, harms, and benefits. Wider implications of the findings The large number of SFEs abandoned and discarded suggests the need for more serious consideration about the disposition of SFEs, prior to egg freezing. In addition, more information should be provided to would-be users about the current fate of and demand for eggs. Trial registration number n/a

AI and Incidental Findings

AI and Incidental Findings

Why genomics researchers are sometimes morally required to hunt for secondary findings

BackgroundGenomic research can reveal ‘unsolicited’ or ‘incidental’ findings that are of potential health or reproductive significance to participants. It is widely thought that researchers have a moral obligation, grounded in the duty of easy rescue, to return certain kinds of unsolicited findings to research participants. It is less widely thought that researchers have a moral obligation to actively look for health-related findings (for example, by conducting additional analyses to search for findings outside the scope of the research question).Main textThis paper examines whether there is a moral obligation, grounded in the duty of easy rescue, to actively hunt for genomic secondary findings. We begin by showing how the duty to disclose individual research findings can be grounded in the duty of easy rescue. Next, we describe a parallel moral duty, also grounded in the duty of easy rescue, to actively hunt for such information. We then consider six possible objections to our argument, each of which we find unsuccessful. Some of these objections provide reason to limit the scope of the duty to look for secondary findings, but none provide reason to reject this duty outright.ConclusionsWe argue that under a certain range of circumstances, researchers are morally required to hunt for these kinds of secondary findings. Although these circumstances may not currently obtain, genomic researchers will likely acquire an obligation to hunt for secondary findings as the field of genomics continues to evolve.

Quarantine, isolation and the duty of easy rescue in public health.

We address the issue of whether, why and under what conditions, quarantine and isolation are morally justified, with a particular focus on measures implemented in the developing world. We argue that the benefits of quarantine and isolation justify some level of coercion or compulsion by the state, but that the state should be able to provide the strongest justification possible for implementing such measures. While a constrained form of consequentialism might provide a justification for such public health interventions, we argue that a stronger justification is provided by a principle of State Enforced Easy Rescue: a state may permissibly compel individuals to engage in activities that entail a small cost to them but a large benefit to others, because individuals have a moral duty of easy rescue to engage in those activities. The principle of State Enforced Easy Rescue gives rise to an Obligation Enforcement Requirement: the state should create the conditions such that submitting to coercive or compulsive measures becomes a fundamental moral duty of individuals, i.e. a duty of easy rescue. When the state can create such conditions, it has the strongest justification possible for implementing coercive or compulsive measures, because individuals have a moral duty to temporarily relinquish the rights that such measures would infringe. Our argument has significant implications for how public health emergencies in the developing world should be tackled. Where isolation and quarantine measures are necessary, states or the international community have a moral obligation to provide certain benefits to those quarantined or isolated.

Facilitating the ethical use of health data for the benefit of society: electronic health records, consent and the duty of easy rescue.

Advances in data science allow for sophisticated analysis of increasingly large datasets. In the medical context, large volumes of data collected for healthcare purposes are contained in electronic health records (EHRs). The real-life character and sheer amount of data contained in them make EHRs an attractive resource for public health and biomedical research. However, medical records contain sensitive information that could be misused by third parties. Medical confidentiality and respect for patients' privacy and autonomy protect patient data, barring access to health records unless consent is given by the data subject. This creates a situation in which much of the beneficial records-based research is prevented from being used or is seriously undermined, because the refusal of consent by some patients introduces a systematic deviation, known as selection bias, from a representative sample of the general population, thus distorting research findings. Although research exemptions for the requirement of informed consent exist, they are rarely used in practice due to concerns over liability and a general culture of caution. In this paper, we argue that the problem of research access to sensitive data can be understood as a tension between the medical duties of confidentiality and beneficence. We attempt to show that the requirement of informed consent is not appropriate for all kinds of records-based research by distinguishing studies involving minimal risk from those that feature moderate or greater risks. We argue that the duty of easy rescue—the principle that persons should benefit others when this can be done at no or minimal risk to themselves—grounds the removal of consent requirements for minimally risky records-based research. Drawing on this discussion, we propose a risk-adapted framework for the facilitation of ethical uses of health data for the benefit of society.This article is part of the themed issue ‘The ethical impact of data science’.

Why (Most) Atheists Have a Duty to Pray

Drawing on principles relating to the duty of easy rescue, I argue that any atheist who is less than wholly certain of the non-existence of a God or gods will in some circumstances be morally obliged to pray.

Internal organs, integral selves, and good communities: opt-out organ procurement policies and the ‘separateness of persons’

Most people accept that if they can save someone from death at very little cost to themselves, they must do so; call this the 'duty of easy rescue.' At least for many such people, an instance of this duty is to allow their vital organs to be used for transplantation. Accordingly, 'opt-out' organ procurement policies, based on a powerfully motivated responsibility to render costless or very low-cost lifesaving aid, would seem presumptively permissible. Counterarguments abound. Here I consider, in particular, objections that assign a moral distinctiveness to the physical boundaries of our bodies and that concern autonomy and trust. These objections are singled out as they seem particularly pertinent to the stress I place on a distinctive benefit of the particular policy I defend. An opt-out system, resting not on the authority of 'presumed consent' but on the recognition of a duty to one another, has the prospect of prompting people to understand more richly the ways in which they are both physically embodied and communally embedded.