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Journal of Bioethical Inquiry

Fabio Macioce
The right to health implies, among other things, that individuals and communities must be allowed to have a voice in decisions concerning the definition of their well-being. The article argues for a more active participation of ethnocultural minorities in healthcare decisions and highlights the relevance of strategies aimed at creating a bottom-up engagement of people and groups, as well as of measures aimed at a broader organizational flexibility, in order to meet migrants' and minorities' needs. Finally, the article clarifies that these strategies are not simply the outcome of a welcoming attitude of the Western healthcare system but may be interpreted as a specific duty resulting from the notion of "particularly vulnerable groups," as formulated by the ECtHR in its case law: when vulnerable groups are at stake, every decision about state actions and rules regarding healthcare should start from an a consideration of the specific conditions and needs of people belonging to vulnerable minority groups...
February 14, 2019: Journal of Bioethical Inquiry
Steven R Sabat
In this article, I explore how methods of investigation can allow us either to appreciate the intact cognitive and social abilities of people with Alzheimer's disease or unwittingly obscure those same abilities. Specifically, I shall assert that (1) the biomedical- quantitative approach, while being generally appropriate for drug efficacy studies, does not allow us to appreciate the many significant strengths possessed by people diagnosed with dementia, (2) qualitative/narrative approaches do so admirably, and (3) understanding the cognitive and social strengths of people diagnosed is of paramount importance for developing optimal care giving approaches and reveals strikingly the shared humanity of those diagnosed with dementia and those deemed healthy...
February 11, 2019: Journal of Bioethical Inquiry
Alisa Grigorovich, Pia Kontos, Alexis P Kontos
Resident-to-resident aggression is quite prevalent in long-term care settings. Within popular and empirical accounts, this form of aggression is most commonly attributed to the actions of an aberrant individual living with dementia characterized as the "violent resident." It is often a medical diagnosis of dementia that is highlighted as the ultimate cause of aggression. This neglects the fact that acts of aggression are influenced by broader structural conditions. This has ethical implications in that the emphasis on individual aberration informs public policy strategies for prevention with a focus on restricting the freedom of individuals using behavioural modification, drugs, or other restraints with the intent to protect others from harm...
February 11, 2019: Journal of Bioethical Inquiry
Marjorie Montreuil, Joé T Martineau, Eric Racine
Patient engagement in healthcare is increasingly discussed in the literature, and initiatives engaging patients in quality improvement activities, organizational design, governance, and research are becoming more and more common and have even become mandatory for certain health institutions. Here we discuss a number of ethical challenges raised by this engagement from patients from the perspectives of research, organizational/quality improvement practices, and patient experiences, while offering preliminary recommendations as to how to address them...
February 11, 2019: Journal of Bioethical Inquiry
Abdul Halim Ibrahim, Noor Naemah Abdul Rahman, Shaikh Mohd Saifuddeen, Madiha Baharuddin
Maqasid al-Shariah based Islamic bioethics is an Islamic bioethics concept which uses the objectives of the Shariah (maqasid al-Shariah) as its approach in analysing and assessing bioethical issues. Analysis based on maqasid al-Shariah based Islamic bioethics will examine any bioethical issues from three main aspects namely intention, method, and output or final goal of the studied issues. Then, the evaluation will be analysed from human interest hierarchy, inclusivity, and degree of certainty. The Islamic bioethics concept is a manifestation of dynamic Islamic jurisprudence which can overcome new complex and complicated bioethical issues such as tri-parent baby technology issues...
February 4, 2019: Journal of Bioethical Inquiry
D Shaw
No abstract text is available yet for this article.
January 24, 2019: Journal of Bioethical Inquiry
Catherine A Sharp, Jennifer S Schulz Moore, Mary-Louise McLaws
For decades, aged care facility residents at risk of pressure ulcers (PUs) have been repositioned at two-hour intervals, twenty-four-hours-a-day, seven-days-a-week (24/7). Yet, PUs still develop. We used a cross-sectional survey of eighty randomly selected medical records of residents aged ≥ 65 years from eight Australian Residential Aged Care Facilities (RACFs) to determine the number of residents at risk of PUs, the use of two-hourly repositioning, and the presence of PUs in the last week of life. Despite 91 per cent (73/80) of residents identified as being at risk of PUs and repositioned two-hourly 24/7, 34 per cent (25/73) died with one or more PUs...
January 22, 2019: Journal of Bioethical Inquiry
Caitlin Davis
The disciplines of ethics, science, and the law often conflict when it comes to determining the limits and boundaries of embryo research. Under current Australian law and regulations, and in various other jurisdictions, research conducted on the embryo in vitro is permitted up until day fourteen, after which, the embryo must be destroyed. Reproductive technology and associated research is rapidly advancing at a rate that contests current societal and ethical limits surrounding the treatment of the embryo. This has brought about the question of the adequacy of the fourteen-day rule and whether it is necessary for it be reconsidered and reformed...
January 11, 2019: Journal of Bioethical Inquiry
Stuart McLennan, Jennifer Moore
BACKGROUND: New Zealand health and disability providers are expected to have local open disclosure policies in place, however, empirical analysis of these policies has not been undertaken. AIM: This study aims to (1) examine the scope and content of open disclosure policies in New Zealand (2) compare open disclosure policies in New Zealand, and (3) provide baseline results for future research. METHODS: Open disclosure policies were requested from all twenty New Zealand District Health Boards in June 2016...
January 7, 2019: Journal of Bioethical Inquiry
Olya Kudina
This article explores the moral significance of technology, reviewing a microfluidic chip for sperm sorting and its use for non-medical sex selection. I explore how a specific material setting of this new iteration of pre-pregnancy sex selection technology-with a promised low cost, non-invasive nature and possibility to use at home-fosters new and exacerbates existing ethical concerns. I compare this new technology with the existing sex selection methods of sperm sorting and Prenatal Genetic Diagnosis. Current ethical and political debates on emerging technologies predominantly focus on the quantifiable risk-and-benefit logic that invites an unequivocal "either-or" decision on their future and misses the contextual ethical impact of technology...
December 27, 2018: Journal of Bioethical Inquiry
Arianne Shahvisi
Women are over-represented within alternative medicine, both as consumers and as service providers. In this paper, I show that the appeal of alternative medicine to women relates to the neglect of women's health needs within scientific medicine. This is concerning because alternative medicine is severely limited in its therapeutic effects; therefore, those who choose alternative therapies are liable to experience inadequate healthcare. I argue that while many patients seek greater autonomy in alternative medicine, the absence of an evidence base and plausible mechanisms of action leaves patients unable to realize meaningful autonomy...
December 20, 2018: Journal of Bioethical Inquiry
Carl Elliott
Libertarians often portray the decision to use enhancement technologies purely as a matter of individual choice, affecting the person who uses them but no one else. Yet individual choices often add up to large social changes that profoundly affect the lives of other people, effectively pushing individual choices in a particular direction. It seems plausible that self-reinforcing loops such as those that have driven the adoption of technologies like cars and air-conditioners might also play a role in the adoption of enhancement technologies, effectively exerting pressure on people to use a technology that they might otherwise resist...
December 19, 2018: Journal of Bioethical Inquiry
Mary Jean Walker
Technological advances are making devices that functionally replace body parts-artificial organs and limbs-more widely used, and more capable of providing patients with lives that are close to "normal." Some of the ethical issues this is likely to raise relate to how such prostheses are conceptualized. Prostheses are ambiguous between being inanimate objects and sharing in the status of human bodies-which already have an ambiguous status, as both objects and subjects. At the same time, the possibility of replacing body parts with artificial objects puts pressure on the normative status typically accorded to human bodies, seemingly confirming that body parts are replaceable objects...
December 18, 2018: Journal of Bioethical Inquiry
Bjørn Hofmann
Human enhancement (HE) is ontologically, epistemologically, and ethically challenging and has stirred a wide range of scholarly and public debates. This article focuses on some conceptual issues with HE that have important ethical implications. In particular it scrutinizes how the concept of human enhancement relates to and challenges the concept of health. In order to do so, it addresses three specific questions: Q1. What do conceptions of HE say about health? Q2. Does HE challenge traditional conceptions of health? Q3...
December 17, 2018: Journal of Bioethical Inquiry
Pier Jaarsma, Petra Gelhaus
In this paper, for the benefit of reflection processes in clinical and in local, regional, and national priority-setting, we aim to develop an ethical theoretical framework that includes both ethical principles and medium-range narratives. We present our suggestion in the particular case of having to choose between treatment interventions for attention deficit hyperactivity disorder (ADHD) and treatment interventions for other conditions or diseases, under circumstances of scarcity. In order to arrive at our model, we compare two distinct ethical approaches: a generalist (principles) approach and a particularist (narratives) approach...
December 5, 2018: Journal of Bioethical Inquiry
Robert French
The term "ethics" covers a multitude of virtues and possibly some sins where ethical perspectives differ. Given the diversity of ethical philosophies there is a question about what common ground can, or should, inform health research ethics. At a minimum it must be consistent with the law. Beyond that, ethics embraces a variety of possible approaches. This raises the question-what criteria are applied in determining the appropriate approach and what standards by way of quality control are applied to its decisional application by ethics committees or other authorities exercising responsibility in this difficult area...
December 5, 2018: Journal of Bioethical Inquiry
Angus Dawson, Christopher F C Jordens, Paul Macneill, Deborah Zion
No abstract text is available yet for this article.
November 28, 2018: Journal of Bioethical Inquiry
Michael A Ashby, Bronwen Morrell
No abstract text is available yet for this article.
December 2018: Journal of Bioethical Inquiry
Sylvia Burrow, Lisa Goldberg, Jennifer Searle, Megan Aston
The following Acknowledgments were omitted in the original publication.
December 2018: Journal of Bioethical Inquiry
Johann J Go
Transgender people have among the highest rates of suicide attempts of any group in society, driven strongly by the perception that they do not belong in the sex of their physical body. Gender reassignment surgery (GRS) is a procedure that can change the transgender person's physical body to accord with their gender identity. The procedure raises important ethical and distributive justice concerns, given the controversy of whether it is a cosmetic or medical procedure and the economic costs associated with performing the procedure...
December 2018: Journal of Bioethical Inquiry
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