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There have been ongoing debates as to how, or even whether, we should clinically classify gender diversity in children through clinical classification manuals. So-called 'depathologizing' is argued as being vital to address the stigma that these children are somehow disordered or sick. Yet one argument in favour of continued clinical classification for transgender and gender non-conforming children is that it better facilitates access to specialist psychological support. I argue that whilst continued clinical classification offers a seemingly pragmatic solution to ensuring access, it does in fact obscure our understanding of the individual needs of these children. In this paper I address fundamental issues that aim to better our understanding of need and thus why a child may benefit from specialist support. I do so by critiquing a paper I nearly wrote, which argued for the ongoing continued classification of gender incongruence in children. Ultimately, I argue that specialist psychological support and care should be driven by the needs of the individual child, as determined by the child and those involved with their care. By bettering our understanding as to why specialist psychological support may be beneficial for some, we move past the focus of such specialist support being provided because of the child's gender diversity. Methodologically the paper may be unusual, in comparison to traditional normative counter-argumentative bioethical position papers, but by presenting an argument for depathologization of gender diversity of children in this way there is also an alternative insight into the methods of bioethics., (© 2020 The Authors. Bioethics published by John Wiley & Sons Ltd.)

The nature of qualitative research is fundamentally different from quantitative research. In depth understanding and exploration of specific phenomena or their significance usually involve a data collection process with a select few participants with whom the researcher interacts over an extended period of time. The participants are not anonymous to the researcher and they also reveal personal information. Research participants' rights need to be protected, even more so in this type of qualitative work. This chapter discusses how ethical decision-making needs to be ongoing during the research process by applying the principles of respect for persons, beneficence and justice. Respecting research participants, involves addressing issues related to informed consent, anonymity and confidentiality while also reflecting on the researcher's impact on the participant and the research context while the research is carried out and also when the research is disseminated. The second principle of beneficence calls for the researcher to ascertain that participants' safety is given utmost importance. Finally, justice refers to ensuring that the burdens and benefits of research are shared fairly without any form of discrimination or manipulation. These principles offer the researcher flexible tools to reflect on ethical decisions as they arise throughout the research process., (Copyright © 2019 Elsevier B.V. All rights reserved.)

The 2014 outbreak of Ebola virus disease (EVD) in West Africa has presented a significant public health crisis to the international health community and challenged U.S. emergency departments (EDs) to prepare for patients with a disease of exceeding rarity in developed nations. With the presentation of patients with Ebola to U.S. acute care facilities, ethical questions have been raised in both the press and medical literature as to how U.S. EDs, emergency physicians (EPs), emergency nurses, and other stakeholders in the health care system should approach the current epidemic and its potential for spread in the domestic environment. To address these concerns, the American College of Emergency Physicians, the Emergency Nurses Association, and the Society for Academic Emergency Medicine developed this joint position paper to provide guidance to U.S. EPs, emergency nurses, and other stakeholders in the health care system on how to approach the ethical dilemmas posed by the outbreak of EVD. This paper will address areas of immediate and potential ethical concern to U.S. EDs in how they approach preparation for and management of potential patients with EVD., (© 2015 by the Society for Academic Emergency Medicine.)

All religions should develop convincing responses to emerging bioethical problems stemming from medical and technological advancements. Additionally, believers need to know their faiths' interpretations of bioethical issues to be able to make medical decisions in line with their religious values. Therefore, Islamic bioethics should provide Muslims with conclusive and credible answers regarding newly rising problems in health care by revisiting the religious norms and decrees. However, the diversity in the Islamic denominations, the traditionalist aspect of the Sunni jurisprudence demanding strict compliance with the scriptural texts, the lack of unanimously accepted authority, and the limited number of academic works in Islamic bioethics (at least in English) complicate exploring new standards or rules for new ethical matters. In this view, the present paper aims to delineate two primary Islamic theological schools and propose al-Ghazali's maslaha as a general framework to analyze bioethical issues in the Sunni tradition. Maslaha allows exercising discretion in light of the protection of five fundamental values: religion, life, reason, lineage, and property. Maslaha has the potential to enable Sunni Muslims to appraise contemporary ethical questions, concerns, and dilemmas through an Islamic view and make more autonomous decisions by having religious guidelines., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The December 2008 White Paper (WP) on "Brain Death" published by the President's Council on Bioethics (PCBE) reaffirmed its support for the traditional neurological criteria for human death. It spends considerable time explaining and critiquing what it takes to be the most challenging recent argument opposing the neurological criteria formulated by D. Alan Shewmon, a leading critic of the "whole brain death" standard. The purpose of this essay is to evaluate and critique the PCBE's argument. The essay begins with a brief background on the history of the neurological criteria in the United States and on the preparation of the 2008 WP. After introducing the WP's contents, the essay sets forth Shewmon's challenge to the traditional neurological criteria and the PCBE's reply to Shewmon. The essay concludes by critiquing the WP's novel justification for reaffirming the traditional conclusion, a justification the essay finds wanting.

The phenomenon of ethically deficient publication in the field of bioethics is practically unknown. In contrast to the numerous articles and regulations on the ethics of biomedical publications, there is a practical absence of articles devoted to consider the nature, types and prevalence of ethically defective publications in the bioethical literature. No regulatory framework for misbehavior in this field has been proposed until now. Certainly, this is a difficult subject. On one side, it is not easy to draw the ethical limits of the freedoms of thought and expression in bioethics, a discipline that flourishes in the open debate of principles, norms, cases, and imaginary scenarios, where the boundaries between rhetoric and misrepresentation are frequently blurred. After showing some examples of minor violations taken from the literature, the author deals with the moral duty to retract fraudulent bioethical articles, especially when they include deliberate distortions of the data or conclusions from published biomedical research. A detailed analysis of a fraudulent article is made (Haring B. ″New Dimensions of Responsible Parenthood. ″ Theological Studies 37, (1976), 120-132), in which an almost systematic distortion of data and opinions of the cited literature has been made. The article, published in a time of intense and critical protest against the encyclical Humanae vitae, pretends to condemn the methods of natural family planning, the only acceptable means to the Pope, on the allegation that those methods were harmful for the embryo and fetus. According to the author, the retraction of Haring's article is necessary.

Abu Ali Ibn Sino (980-1037) is worldwide known in medical history as Avicenna. In general, Avicenna's papers are filled with humanistic ideas. It is, first of all, a successful attempt of the development of spiritual and moral foundation of medicine, or using modern words, bioethics. The book "canon of physician sciences" written by Avicenna, represents plenty of humanistic ideas: the subject is not only person herself/himself but her/his lifestyle in all variety of cultural, legal, religious and others sides of the life. Necessity of such approach is dictated, in particular, that bioethics anew revives in physicians deontological approach to people.

Abstract Background In the last years, there has been an increase in publication of systematic reviews of normative (“argument-based”) literature or of normative information (such as ethical issues) in bioethics. The aim of a systematic review is to search, select, analyse and synthesise literature in a transparent and systematic way in order to provide a comprehensive and unbiased overview of the information sought, predominantly as a basis for informed decision-making in health care. Traditionally, one part of the procedure when conducting a systematic review is an appraisal of the quality of the literature that could be included. Main text However, while there are established methods and standards for appraising e.g. clinical studies or other empirical research, quality appraisal of normative literature (or normative information) in the context of a systematic review is still rather a conundrum – not only is it unclear how it could or should be done, but also the question whether it necessarily must be done is not settled yet. Based on a pragmatic definition of “normative literature” as well as on a typology of different types of systematic reviews of normative literature/information, this paper identifies and critically discusses three possible strategies of conducting quality appraisal. Conclusions The paper will argue that none of the three strategies is able to provide a general and satisfying solution to the problems associated with quality appraisal of normative literature/information. Still, the discussion of the three strategies allows outlining minimal conditions that elaborated strategies have to meet in future, and facilitates sketching a theoretically and practically promising strategy.

Background. Registrars in specialisation training programmes encounter numerous difficulties in completing the research component of the Master of Medicine degree. Poor patient record-keeping hinders the research process. Objectives. To investigate current types of medical patient record-keeping systems (electronic v. paper) in training health facilities, and the effect data accessibility has on specialist training and research. Methods. This was a mixed-methods study that included both descriptive and analytical components. Of 610 postgraduate students enrolled in the University of KwaZulu-Natal College of Health Sciences Master of Medicine programme, 168 completed a cross-sectional survey to collect data and 11 did follow-up interviews. The survey and interviews explored issues related to medical record-keeping in the participants' department or hospital, emphasising their experiences with data access while conducting research. The quantitative data were analysed using descriptive statistics, and the qualitative data were analysed thematically. Ethical approval was obtained from the institution's Biomedical Research Ethics Committee. Results. Of the 168 participants, 94 (56%) reported that problems with data access hindered their research, while 56 (33%) indicated that data access did not affect their research. Only 30 participants (18%) had no difficulty in obtaining data for their research, while the rest (n=138; 82%) experienced varying degrees of difficulty. A total of 110 participants (65%) indicated that paper-based record-keeping was mainly being used in their department or hospital, while electronic record-keeping was reported by the rest (n=58; 35%). Many (n=125; 74%) expressed the need to improve hospital data management practices, and 39 (23%) reported that plans were being implemented to improve these practices. Participants expressed frustration with regard to accessing data even in departments that used electronic systems, and they raised concerns regarding data security. Conclusion. The migration to electronic patient record-keeping has not yet been implemented in many hospitals, with poor patient record-keeping affecting training and research. [ABSTRACT FROM AUTHOR]

1. 9:30 am FEAR TO FAIL, FEAR TO SHARE: NEGATIVE EFFECTS OF SOCIAL MEDIA ON THE DESIGN STUDENT. Benjamin Bush, Auburn University. Social media is one of the most pervasive [...]

Culture, health, and medicine intersect in various ways-and not always without friction. This paper examines how liberal multicultural states ought to interact with diverse communities which hold different health-related or medical beliefs and practices. The debate is fierce within the fields of medicine and bioethics as to how traditional medicines ought to be regarded. What this debate often misses is the relationship that medical traditions have with cultural identity and the value that these traditions can have beyond the confines of the clinical setting. This paper will attempt to bring some clarity to the discussion. In so doing, it will delve into some controversial areas: (1) the debate around whether liberal states ought to embrace multiculturalism, (2) the existence and nature of group-differentiated rights, (3) the question of whether healthcare systems ought to embrace medical pluralism, and (4) what this would entail for policymakers, clinicians, and patients. Ultimately, I argue that liberal democratic states with multicultural populations ought to recognize medical pluralism as a matter of respecting group-differentiated and individual human rights., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

This article assesses the role of an important Russian public institution, the Russian Orthodox Church (ROC), in shaping the religious discourse on bioethics in Russia. An important step in this process was the approval of 'The Basis of the Social Concept of the Russian Orthodox Church' (2000), one chapter of which is devoted to bioethics. However, certain inadequacies in the creation of this document resulted in the absence of a clear position of the Russian Orthodox Church on some end-of-life issues, reproductive technologies, embryo stem cells, and other topics.Using the example of reproductive dilemmas, the author researches how the ROC clarifies its teaching on issues relating to bioethics. In the 2010s the ROC introduced a new method of taking into account the views of believers and the articulation of the church's position. This article examines the extensive public discussion of a new document, 'Ethical issues Associated with In Vitro Fertilization'., (© 2022. Monash University.)

The global response to the recent coronavirus pandemic has revealed an ethical crisis in public health. This article analyses key pandemic public health policies in light of widely accepted ethical principles: the need for evidence, the least restrictive/harmful alternative, proportionality, equity, reciprocity, due legal process, and transparency. Many policies would be considered unacceptable according to pre-pandemic norms of public health ethics. There are thus significant opportunities to develop more ethical responses to future pandemics. This paper serves as the introduction to this Special Issue of Monash Bioethics Review and provides background for the other articles in this collection., (© 2022. The Author(s).)

Precision medicine aims to tailor medical treatment to match individual characteristics and to stratify individuals to concentrate benefits and avoid harm. It has recently been joined by precision public health-the application of precision medicine at population scale to decrease morbidity and optimise population health. Newborn preventive genomic sequencing (NPGS) provides a helpful case study to consider how we should approach ethical questions in precision public health. In this paper, I use NPGS as a case in point to argue that both precision medicine and precision public health need public health ethics. I make this argument in two parts. First, I claim that discussions of ethics in precision medicine and NPGS tend to focus on predominantly individualistic concepts from medical ethics such as autonomy and empowerment. This highlights some deficiencies, including overlooking that choice is subject to constraints and that an individual's place in the world might impact their capacity to 'be responsible'. Second, I make the case for using a public health ethics approach when considering ethics and NPGS, and thus precision public health more broadly. I discuss how precision public health needs to be construed as a collective enterprise and not just as an aggregation of individual interests. I also show how analysing collective values and interests through concepts such as solidarity can enrich ethical discussion of NPGS and highlight previously overlooked issues. With this approach, bioethics can contribute to more just and more appropriate applications of precision medicine and precision public health, including NPGS., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.)

The American health care system increasingly conflates physician "productivity" with true clinical efficiency. In reality, inordinate time pressure on physicians compromises quality of care, decreases patient satisfaction, increases clinician burnout, and costs the health care system a great deal in the long term even if it is financially expedient in the short term. Inadequate time to deliver care thereby conflicts with the core principles of biomedical ethics, including autonomy, beneficence, nonmaleficence, and justice. We propose that the health care system adjust its focus to recognize the nonmonetary value of physician time while still realizing the need to deploy resources as effectively as possible, a concept we describe as "ethical efficiency.", (© 2022 The Hastings Center.)

In the 1960s, tucked away at Yale Divinity School, there was a remarkable confluence of bioethics scholars under the tutelage of James M. Gustafson. His students were Jim Childress, Albert R. Jonsen, Tom Beauchamp, LeRoy Walters, Jim Drane, and Stanley Hauerwas, among others. Jonsen later recalled, "That little group was really the beginning of scholarly bioethics." Yet despite Gustafson's influence on the founding generation of bioethics scholars and his prominence as a leading mid-century Christian theologian, his legacy in bioethics is unsecured. This is an unfortunate omission, as Gustafson's contributions to bioethics were not limited to the classroom. In 1969, he brought Paul Ramsey to Yale to deliver the Lyman Beecher Lectures, a collection of talks that would coalesce into Ramsey's The Patient as Person. Gustafson also advised Daniel Callahan as Callahan and Willard Gaylin founded The Hastings Center, on whose founding board of directors Gustafson later served. Through archival research and interviews with Gustafson's former students and colleagues, we recount his biography, consider his pedagogy, and examine the theological pragmatism that informed his engagement with his students and his intellectual commitments before the birth of bioethics. By reviewing Gustafson's contributions to the nascent field of bioethics, we seek to understand why his legacy has been forgotten and to introduce him to a new generation of bioethics scholars., (© 2022 The Hastings Center.)

In light of converging technologies, there is a clear sense that ethicists of various technological domains are coming together. Or, that they should come together. Yet, despite increasing cooperation and boundary-crossing in various fields of the ethics of technology, these efforts remain mostly at topical level. Relatively little attention has been given to issues on methodologies. The current paper aims to contribute to the current research by raising the methodological issues. In this paper, my objective is to argue that ethics of Information Technology (or Information Ethics (IE)) can benefit from the insights in other fields of the ethics of technology. Drawing the insights from other fields of the ethics of technology, I shall propose a systematic account of an Empirical Information Ethics (EIE)

Innovation in ethics pedagogy has continued to evolve and incorporate other forms of storytelling aimed at improving student engagement and learning. The use of bioethics narratives in feature-length films, medical television shows, or short clips in the classroom has a well-established history. In parallel, screenplays present an opportunity for an active approach to ethical engagement. We argue that screenplays and screenwriting provide a rich supplement to current medical ethics teaching and serve as a strong form of reflective learning., (© 2019. Springer Science+Business Media, LLC, part of Springer Nature.)

This paper provides a perspective on where contemporary Muslim responses to biomedical-ethical issues stand to date. There are several ways in which Muslim responses to biomedical ethics can and have been studied in academia. The responses are commonly divided along denominational lines or under the schools of jurisprudence. All such efforts classify the responses along the lines of communities of interpretation rather than the methods of interpretation. This research is interested in the latter. Thus, our criterion for classification is the underlying methodology behind the responses. The proposed classification divides Muslim biomedical-ethical reasoning into three methodological categories: 1) textual, 2) contextual, and 3) para-textual., (© 2023. The Author(s).)

The action required to stem the environmental and social implications of climate change depends crucially on how humankind shapes technology, economy, lifestyle and policy. With transport CO2 emissions accounting for about a quarter of the total, we examine the contribution of CO2 output by scientific travel. Thankfully for the reputation of the scientific community, CO2 emissions associated with the trips required to present a paper at a scientific conference account for just 0.003% of the yearly total. However, with CO2 emissions for a single conference trip amounting to 7% of an average individual’s total CO2 emissions, scientists should lead by example by demonstrating leadership in addressing the issue. [ABSTRACT FROM AUTHOR]

This discussion article examines narrative positioning related to pain management for people who use substances at the end of life. We explore how dominant narrative genres associated with biomedicine, such as 'restitution' and narratives common within the context of drug services such as 'recovery' can hinder effective pain management within this population. We argue that these discourses can marginalise the ethical self-identity of patients who use substances at the end of life. It can also trouble health and social care professionals in supporting patients and generating counter-narratives that challenge those often associated with substance use. Stigma is a common experience for this population with stereotyping as 'junkies' and associated with criminality. They are positioned as drug-seeking, and this requires more surveillance at the end of life when opioid therapy is potentially more available and authorised. This can make it challenging to generate 'companion' stories that are positive and maintain moral adequacy. Dominant biomedical narrative genres often prevent the recognition of the fractured stories that people using substances can often present with. This can lead to narrative silencing and to the under treatment of pain. The person's self-identity is invested in narratives of recovery, and opioid use symbolises their addicted past because for practitioners, this population is at clinical risk with the potential for drug seeking behaviours. Whilst not requiring formal ethical review this discussion paper was constructed in accordance with good scientific practice with the work of other researchers respected and cited appropriately. [ABSTRACT FROM AUTHOR]

In the development of the Universal Declarations of Bioethics and Human Rights (UDBHR) of UNESCO, the Protestant tradition did not participate in the conversation. This treatise is a humble contribution. The global community is convinced that the present generation can have a positive and negative impact on future generations. Article 16 of the UDBHR expresses serious concern about the negative impact of technology in the context of the human, animal and plant genome in particular, as well as the environment in general. The Protestant concept of the covenant provides a solid theological grounding for article 16 of the UDBHR. In light of this reasoning, article 16 of the UDBHR, which has the purpose of promoting the health of future generations, can fully be defended by Protestant ethics and included in the prophetic message of the Protestant faith tradition.

In this article, I reject the "principlism" of Tom Beauchamp and James Childress and argue that respect for autonomy is, and ought to be, the fundamental value of bioethics. To do so, I offer a reconstruction of what I call the field's "founding myth," a genealogy that affords primacy to the right to be respected as a human being with dignity. Next, I examine the relationship between this basic right and a derivative right of autonomy. I suggest that principlism has promulgated an uncharitable understanding of respect for autonomy, one that ensures that the principle cannot occupy the central position I claim for it. Finally, I sketch a more plausible understanding of respect for autonomy and explore its implications., (© 2023 The Hastings Center.)

It is a common practice for authors of an academic work to thank the anonymous reviewers at the journal that is publishing it. Allegedly, scholars thank the reviewers because their comments improved the paper and thanking them is a proper way to show gratitude to them. Yet often, a paper that is eventually accepted by one journal is first rejected by other journals, and even though those journals' reviewers also supply comments that improve the quality of the work, those reviewers are not customarily thanked. We contacted prominent scholars in bioethics and philosophy of medicine and asked whether thanking such reviewers would be a welcome trend. Having received responses from 107 scholars, we discuss the suggested proposal in light of both philosophical argument and the results of this survey. We argue that when an author's work is published, the author should thank the reviewers whose comments improved the paper regardless of whether those reviewers' journals rejected or accepted the work. That is because scholars should show gratitude to those who deserve it, and those whose comments improved the paper deserve gratitude. We also consider objections against this practice raised by scholars and show why they are not entirely persuasive. [ABSTRACT FROM AUTHOR]

Objectives: This document provides an English translation of the Israeli Joint Commission's national guidelines for triaging severely ill patients during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Four subcommittees of medical, legal, ethical-social, and religious experts developed the general principles and practical medical criteria for triaging scarce life-saving resources. Results: The guidelines provide an overview of general principles as well as pragmatic medical criteria and a practical triage protocol to be followed should the healthcare system be overwhelmed due to COVID-19. Issues covered include triggers for activating the guidelines, guiding ethical, legal, and religious principles, equity in access, fair distribution, transparency, consistency, palliation, medical policy prioritization, problem-solving mechanisms, and public trust. Conclusions: The Israeli consensus document and pragmatic medical triage protocol offer a societal and medical roadmap for allocating scarce resources during the COVID-19 pandemic or other disasters. [ABSTRACT FROM AUTHOR]