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Biological samples containing DNA that is attributed to deceased relatives, can now undergo genetic testing at a reasonable cost due to revolutionary improvements in sampling, sequencing, and analytical techniques. This artifact DNA testing, or 'artDNA', includes genetic analysis of hair locks, stamps, envelopes with saliva traces or teeth. ArtDNA can reveal valuable information about a deceased relative or one's genetic background, but it also presents novel ethical dilemmas and legal uncertainties for genetic researchers and commercial testing services. In this paper, we provide an analysis of some of the unique ethical and legal risks of such testing and provide needed recommendations for practitioners of private family artDNA testing. ArtDNA testing generates ethical and legal risks regarding the privacy and autonomy of deceased individuals, the rights of living relatives over their ancestor's genetic information, and the rights of living persons to control their own genetic information. To mitigate these risks, practitioners can conduct certain preliminary testing to ascertain the identity of a DNA donor and estimate the time that has elapsed postmortem. Generally, the ethical and legal concerns will be higher when a shorter period has passed between the death of the DNA donor and the time of artifact DNA testing. Regardless, all artDNA testing present some risks, and practitioners should exercise professional judgement as necessary. [ABSTRACT FROM AUTHOR]

This paper explores ethical debates associated with the UK COVID-19 contact tracing app that occurred in the public news media and broader public policy, and in doing so, takes ethics debate as an object for sociological study. The research question was: how did UK national newspaper news articles and grey literature frame the ethical issues about the app, and how did stakeholders associated with the development and/or governance of the app reflect on this? We examined the predominance of different ethical issues in news articles and grey literature, and triangulated this using stakeholder interview data. Findings illustrate how news articles exceptionalised ethical debate around the app compared to the way they portrayed ethical issues relating to 'manual' contact tracing. They also narrowed the debate around specific privacy concerns. This was reflected in the grey literature, and interviewees perceived this to have emerged from a 'privacy lobby'. We discuss the findings, and argue that this limited public ethics narrative masked broader ethical issues. [ABSTRACT FROM AUTHOR]

The proliferation of digital data and internet-based research technologies is transforming the research landscape, and researchers and research ethics communities are struggling to respond to the ethical issues being raised. This paper discusses the findings from a collaborative project that explored emerging ethical issues associated with the expanding use of digital data for research. The project involved consulting with researchers from a broad range of disciplinary fields. These discussions identified five key sets of issues and informed the development of guidelines orientated to meet the needs of researchers and ethics committee members. We argue that establishing common approaches to assessing ethical risks of research involving digital data will promote consistency in the ethical standards for research, enable the smooth functioning of ethics committees, and sustain public confidence in research. We conclude with recommendations for the development of educational resources for ethics committees, data management guidelines and further public education. [ABSTRACT FROM AUTHOR]

The application of artificial intelligence (AI) in hospitals yields many advantages but also confronts healthcare with ethical questions and challenges. While various disciplines have conducted specific research on the ethical considerations of AI in hospitals, the literature still requires a holistic overview. By conducting a systematic discourse approach highlighted by expert interviews with healthcare specialists, we identified the status quo of interdisciplinary research in academia on ethical considerations and dimensions of AI in hospitals. We found 15 fundamental manuscripts by constructing a citation network for the ethical discourse, and we extracted actionable principles and their relationships. We provide an agenda to guide academia, framed under the principles of biomedical ethics. We provide an understanding of the current ethical discourse of AI in clinical environments, identify where further research is pressingly needed, and discuss additional research questions that should be addressed. We also guide practitioners to acknowledge AI-related benefits in hospitals and to understand the related ethical concerns. [ABSTRACT FROM AUTHOR]

This paper attempts to better define the areas of conflict and agreement between value ethics and the theoretical ethics of the market processes at work in the biotechnology industry. Despite the apparent lack of ethics in an oligopolistically competitive pharmaceuticals industry, the paper concludes that the current stage of development of the medical biotechnology subindustry offers unparalleled opportunities for ethical systems to influence the market-based development of biotechnology. Ethical conversations between doctors and biologists with ethicists can help the market absorb more of the reflective wisdom that ethics brings when discussing such issue areas as justice, patents of the human genome, and modifications of the human genome. If conversations between ethicists and biotechnological managers and doctors are successful the metaphors of market-based financing may be refined and the knowledge base of the good increased. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) is set to transform healthcare. Key ethical issues to emerge with this transformation encompass the accountability and transparency of the decisions made by AI-based systems, the potential for group harms arising from algorithmic bias and the professional roles and integrity of clinicians. These concerns must be balanced against the imperatives of generating public benefit with more efficient healthcare systems from the vastly higher and accurate computational power of AI. In weighing up these issues, this paper applies the deliberative balancing approach of the Ethics Framework for Big Data in Health and Research (Xafis et al. 2019). The analysis applies relevant values identified from the framework to demonstrate how decision-makers can draw on them to develop and implement AI-assisted support systems into healthcare and clinical practice ethically and responsibly. Please refer to Xafis et al. (2019) in this special issue of the Asian Bioethics Review for more information on how this framework is to be used, including a full explanation of the key values involved and the balancing approach used in the case study at the end of this paper. [ABSTRACT FROM AUTHOR]

Discussion of uses of biomedical data often proceeds on the assumption that the data are generated and shared solely or largely within the health sector. However, this assumption must be challenged because increasingly large amounts of health and well-being data are being gathered and deployed in cross-sectoral contexts such as social media and through the internet of (medical) things and wearable devices. Cross-sectoral sharing of data thus refers to the generation, use and linkage of biomedical data beyond the health sector. This paper considers the challenges that arise from this phenomenon. If we are to benefit fully, it is important to consider which ethical values are at stake and to reflect on ways to resolve emerging ethical issues across ecosystems where values, laws and cultures might be quite distinct. In considering such issues, this paper applies the deliberative balancing approach of the Ethics Framework for Big Data in Health and Research (Xafis et al. 2019) to the domain of cross-sectoral big data. Please refer to that article for more information on how this framework is to be used, including a full explanation of the key values involved and the balancing approach used in the case study at the end. [ABSTRACT FROM AUTHOR]

Through the exponential growth in digital devices and computational capabilities, big data technologies are putting pressure upon the boundaries of what can or cannot be considered acceptable from an ethical perspective. Much of the literature on ethical issues related to big data and big data technologies focuses on separate values such as privacy, human dignity, justice or autonomy. More holistic approaches, allowing a more comprehensive view and better balancing of values, usually focus on either a design-based approach, in which it is tried to implement values into the design of new technologies, or an application-based approach, in which it is tried to address the ways in which new technologies are used. Some integrated approaches do exist, but typically are more general in nature. This offers a broad scope of application, but may not always be tailored to the specific nature of big data related ethical issues. In this paper we distil a comprehensive set of ethical values from existing design-based and application-based ethical approaches for new technologies and further focus these values to the context of emerging big data technologies. A total of four value lists (from techno-moral values, value-sensitive design, anticipatory emerging technology ethics and biomedical ethics) were selected for this. The integrated list consists of a total of ten values: human welfare, autonomy, non-maleficence, justice, accountability, trustworthiness, privacy, dignity, solidarity and environmental welfare. Together, this set of values provides a comprehensive and in-depth overview of the values that are to be taken into account for emerging big data technologies. [ABSTRACT FROM AUTHOR]

Genetics and ethics have had numerous convergences and divergences over time. From Darwin through the Asilomar Conference and the Universal Declaration on the Human Genome and Human Rights, much has been achieved, but much still remains to be done. The use of biological materials that are already being stored and the adequacy of new technologies, such as clustered regularly interspaced short palindromic repeats (CRISPR), are some of the current challenges of this possible and necessary interaction. This paper will discuss some ethical aspects involved in current genetics. [ABSTRACT FROM AUTHOR]

Drawing from perspectives of both bioethics and anthropology, this article explores how the boundaries between personal and relational privacy are negotiated by patients and practitioners in the context of an emerging domain of cancer genetics in Brazil. It reflects on the place of informed consent in the history of bioethics in North America in contrast to the development of bioethics in Brazil and the particular social cultural context in which consent is sought in Brazilian public health care. Making use of empirical research with families and individuals receiving genetic counselling related to increased genetic risk for cancer, in genetic clinics in southern Brazil, it examines how informed consent is linked to the necessary movement between personal and relational privacy. The paper illustrates the value of a particular tool known as a 'sociogram' to examine the complex interpersonal dynamics that arise in negotiating informed consent at the interface between the family and the individual in Brazil. The paper, therefore, points to the scope of further interdisciplinary exchanges between anthropology and bioethics, confronting the new challenges that arise in the context of medical genetics in developing country. [ABSTRACT FROM AUTHOR]

Ethics should guide the design of electronic health records (EHR), and recognized principles of bioethics can play an important role. This approach was recently adopted by a team of informaticists who are designing and testing a system where patients exert granular control over who views their personal health information. While this method of building ethics in from the start of the design process has significant benefits, questions remain about how useful the application of bioethics principles can be in this process, especially when principles conflict. For instance, while the ethical principle of respect for autonomy supports a robust system of granular control, the principles of beneficence and nonmaleficence counsel restraint due to the danger of patients being harmed by restrictions on provider access to data. Conflict between principles has long been recognized by ethicists and has even motivated attacks on approaches that state and apply principles. In this paper, we show how using ethical principles can help in the design of EHRs by first explaining how ethical principles can and should be used generally, and then by discussing how attention to details in specific cases can show that the tension between principles is not as bad as it initially appeared. We conclude by suggesting ways in which the application of these (and other) principles can add value to the ongoing discussion of patient involvement in their health care. This is a new approach to linking principles to informatics design that we expect will stimulate further interest. [ABSTRACT FROM AUTHOR]

Generalization – the ability of AI systems to apply and/or extrapolate their knowledge to new data which might differ from the original training data – is a major challenge for the effective and responsible implementation of human-centric AI applications. Current debate in bioethics proposes selective prediction as a solution. Here we explore data-based reasons for generalization challenges and look at how selective predictions might be implemented technically, focusing on clinical AI applications in real-world healthcare settings. [ABSTRACT FROM AUTHOR]

Despite the passage of H.R. 3590 in the 111th Congress, the national healthcare debate in the United States continues, with repeal or modification of the Patient Protection and Affordable Care Act under ongoing consideration. Reference is often made to morality or ethics, but typically in general terms only. This paper elucidates themes from one system of moral theology, namely Jewish healthcare ethics, that would valuably inform this debate. Themes include 'covenant,' 'holiness,' 'justice,' 'mercy,' 'for the sake of peace,' 'to save a life,' 'peoplehood,' 'repair of the world,' 'repentance,' and 'jubilee.' Policy-related, economic, political, and moral challenges to acting on these principles are discussed. [ABSTRACT FROM AUTHOR]

Three widely accepted principles – autonomy, beneficence and justice – provide a useful analytic framework for considering controversies and conflicts in bioethics. Since these principles capture key concepts found in diverse normative theories they provide a starting point from which consistent ethical analysis and comparison can begin. While justice is commonly discussed in the business ethics literature, the other two principles are not widely discussed. This paper investigates whether the principles of autonomy and beneficence provide a framework that is equally useful for framing issues in business ethics. It is argued that they do. First, the principle of autonomy, with its associated notions of informed consent, privacy, confidentiality, voluntariness, self-mastery, and so on, provides a consistent approach to the analysis of diverse issues that arise in business ethics from market research to recruitment practices. Second, it is argued that the relationships between a business and its stakeholders ground duties of beneficence. The principle of beneficence provides a framework for considering the issues that arise in these relationships. [ABSTRACT FROM AUTHOR]

The importance of seeking out, and seeking to understand, diverse perspectives in bioethics is the common theme uniting the papers in this July 2002 issue of I Asian Bioethics Review i . Thus, for this issue, we present the work of Noorina Noorfuad who highlights the paucity of religious perspectives relating to neuroethics, in particular from a standpoint of Islamic principles [https://link.springer.com/article/10.1007/s41649-022-00203-8 U ] u . [Extracted from the article]

The June 2021 issue of the I Asian Bioethics Review i picks up where the March 2021 Special Issue left off. This last issue explored the extensive interconnections between reproductive practices, populations politics, and bioethics, emphasising how many of the issues are brought into even more acute focus in light of the COVID-19 pandemic. The second strand of papers in this issue relates to ethical responses to the COVID-19 pandemic. [Extracted from the article]

The discovery of clustered regularly interspaced short palindromic repeats (CRISPR) and the CRISPR-mediated protein 9 (CRISPR-Cas9) immediately revealed numerous potential therapeutic applications. Although CRISPR-Cas9 will most likely be useful for addressing issues such as genetic diseases and related medical issues, use of this modality for germline modification generates complex ethical questions regarding the safety and efficacy, human genetic enhancement, and "designer" babies. In this article, the case of the He Jiankui affair is used as an example of the potential for unregulated use of CRISPR-Cas9 technology. In 2018, Dr He Jiankui reported that he had successfully edited human embryos. This work clearly violates all international principles of bioethics. As such, the purpose of this paper is to explore the ethical challenges inherent in the use of CRISPR-Cas9 for human germline editing from the perspectives of the goals of Islamic law (Maqasid al Shari'a) and the major jurisprudential maxims (Qawaid Fiqhiyyah). We argue that from an Islamic standpoint, the therapeutic application of CRISPR-Cas9 for germline editing may be permissible if the safety and efficacy concerns are resolved and if the principles of Maqasid al-Shari'a are fulfilled. [ABSTRACT FROM AUTHOR]

This April 2022 issue of the Asian Bioethics Review is a showcase of diversity of experience and perspective in bioethics across the Asian region. A significant part of this moral distress was caused by the challenges and frustrations of trying to deliver patient-centred care in the face of unprecedented practices of social distancing and arms' length decision-making that was proscribed by public health policies. The paper also offers an important set of recommendations that seeks to align good research conduct with an understanding of local cultural practices, experiences, and expectations. [Extracted from the article]

Millions of skeletal remains from South Asia were exported in red markets (the underground economy of human tissues/organs) to educational institutions globally for over a century. It is time to recognize the personhood of the people who were systematically made into anatomical objects and acknowledge the scientific racism in creating and continuing to use them. [ABSTRACT FROM AUTHOR]

Innovation in healthcare and biomedicine is in decline, yet there exist no widely-known alternatives to traditional brainstorming that can be employed for innovative idea generation. McCaffrey's Innovation Enhancing Techniques (IETs) were developed to enhance creative problem-solving by helping the solver to overcome common psychological obstacles to generating innovative ideas. These techniques were devised for engineering and design problems, which involve solving practical goals using physical materials. Healthcare and science problems however often involve solving abstract goals using intangible resources. Here we adapt two of McCaffrey's IETs, BrainSwarming and the Generic Parts Technique, to effectively enhance idea generation for such problems. To demonstrate their potential, we apply these techniques to a case study involving the use of blockchain technologies to facilitate ethical goals in biomedicine, and successfully identify 100 potential solutions to this problem. Being simple to understand and easy to implement, these and other IETs have significant potential to improve innovation and idea generation in healthcare, scientific, and technological contexts. By catalysing idea generation in problem-solving, these techniques may be used to target the innovative stagnation currently facing the scientific world. [ABSTRACT FROM AUTHOR]

The deep interconnections between biology, population politics, and ethics have been strongly brought to the fore by the ongoing COVID-19 pandemic. As the most populous countries in the world, India and China have come to mark our collective conscience in significant ways (Eklund and Purewal [6]; Kaur [13]). Resulting familial, kinship, and policy shifts are paramount in the ways in which China and India are approaching reproductive technologies and demographic transformation. The papers presented in this special issue emerged from a conference on 'Reproduction, Demography and Cultural Anxieties in India and China in the 21 SP st sp Century' held at New Delhi, India, in February 2020. [Extracted from the article]

Technological advances have been a driving force in the practice of medicine. From the discovery of x-rays' medical applications to the utilization of dialysis and surgical transplantation of organs, technology has presented new opportunities, and at times, ethical challenges for physicians. In recent years, the increased proliferation of social media tools has had a significant impact on how people engage with one another, and how they want to engage with their healthcare providers. Medical schools have begun to examine some of the issues surrounding use of social media in the context of professionalism in their curricula. Many of the physicians already in practice are left to grapple with how to learn about and wield social media in not only a professional capacity and their personal lives, but often where the two intersect. This paper will explore both opportunities for social media engagement and ethical concerns such usage presents to physicians and in particular to those in the field of musculoskeletal medicine. [ABSTRACT FROM AUTHOR]

The well-being of students and staff directly affects their output and efficiency. This study presents the results of two focus groups conducted in 2022 within a two-phase project led by the Applied Biomedical and Signal Processing Intelligent e-Health Lab, School of Engineering at the University of Warwick, and British Telecom within "The Connected Campus: University of Warwick case study" program. The first phase, by involving staff and students at the University of Warwick, aimed at collecting preliminary information for the subsequent second phase, about the feasibility of the use of Artificial Intelligence and Internet of Things for well-being support on Campus. The main findings of this first phase are interesting technological suggestions from real users. The users helped in the design of the scenarios and in the selection of the key enabling technologies which they considered as the most relevant, useful and acceptable to support and improve well-being on Campus. These results will inform future services to design and implement technologies for monitoring and supporting well-being, such as hybrid, minimal and even intrusive (implantable) solutions. The user-driven co-design of such services, leveraging the use of wearable devices and Artificial Intelligence deployment will increase their acceptability by the users. [ABSTRACT FROM AUTHOR]

The Indiana Global Health Research Working Conference of October 2012 was convened by a planning committee representing Indiana's research-intensive universities (Indiana University, Purdue University, and the University of Notre Dame). The event was organized as an open-space meeting with six thematic emphases and pre-conference keynote papers. Within their domains of common interest, attendees developed forme fruste research project abstracts that represent a future-oriented agenda for global health research. The organizational principles and purposes of this meeting are explicated with a concluding commentary on the agenda for research. [ABSTRACT FROM AUTHOR]

In recent years there has been growing scholarly interest in the relationship between bioethics and human rights. The majority of this work has proposed that the normative and institutional frameworks of human rights can usefully be employed to address those bioethical controversies that have a global reach: in particular, to the genetic modification of human beings, and to the issue of access to healthcare. In response, a number of critics have urged for a degree of caution about applying human rights to such controversies. In particular, they have claimed that human rights have unresolved distributive and foundational problems. Interestingly, however, some of these critics have gone on to suggest that it might be possible to draw on certain bioethical insights to remedy these problems with human rights. This paper evaluates these recent attempts to apply insights from bioethics to the theory and practice of human rights. It argues that while these insights do not constitute an entirely new and original contribution to human rights thinking, they do force human rights scholars and campaigners to reflect on some key issues. First of all, they force us to question the prevalent idea that human rights are always 'inviolable trumps'. Secondly, they demand that we pay close attention to the 'fairness' of the institutions we charge with determining our concrete rights. And finally, and perhaps most radically, these insights challenge the notion that human rights are held exclusively by members of the human species. [ABSTRACT FROM AUTHOR]

For about five decades the phrase 'sanctity-of-life' has been part of the Anglo-American biomedical ethical discussion related to abortion and end-of-life questions. Nevertheless, the concept's origin and meaning are unclear. Much controversy is based on the mistaken assumption that the concept denotes the absolute value of human life and thus dictates a strict prohibition on euthanasia and physician-assisted suicide. In this paper, I offer an analysis of the religious and philosophical history of the idea of 'sanctity-of-life.' Drawing on biblical texts and interpretation as well as Kant's secularization of the concept, I argue that 'sanctity' has been misunderstood as an ontological feature of biological human life, and instead locate the idea within the historical virtue-ethical tradition, which understands sanctification as a personal achievement through one's own actions. [ABSTRACT FROM AUTHOR]

This paper summarizes survey and interview results from a cross-sectional study of New Zealand health care chaplaincy personnel concerning their involvement in multiple bioethical issues encountered by patients, families and clinical staff within the health care context. Some implications of this study concerning health care chaplaincy, ecclesiastical institutions, health care institutions and government responsibilities are discussed and recommendations presented. [ABSTRACT FROM AUTHOR]

Public-private partnerships (PPPs) are established to specifically harness the potential of Big Data in healthcare and can include partners working across the data chain—producing health data, analysing data, using research results or creating value from data. This domain paper will illustrate the challenges that arise when partners from the public and private sector collaborate to share, analyse and use biomedical Big Data. We discuss three specific challenges for PPPs: working within the social licence, public antipathy to the commercialisation of public sector health data, and questions of ownership, both of the data and any resulting intellectual property or products. As a specific example we consider the case of the UK National Health Service (NHS) providing patient data to Google's DeepMind AI program to develop a diagnostic app for kidney disease. This article is an application of the framework presented in this issue of ABR (Xafis et al. 2019). Please refer to that article for more information on how this framework is to be used, including a full explanation of the key values involved and the balancing approach used in the case study at the end. We use four specific values to help analysis these issues: public benefit, stewardship, transparency and engagement. We demonstrate how the Deliberative Framework can support ethical governance of PPPs involving biomedical big data. [ABSTRACT FROM AUTHOR]

A female physician who was serving as a first-year medicine resident in Manhattan in September 2001 writes this paper. It details her experience of signing up for military service as a result of the September 11th attack on the United States. She lays out the surroundings, atmosphere, and reactions of those around her during the attack and details her own personal motivations for joining the military, her need to take control and help those in need heal while also trying to heal herself. Grateful, yet haunted by her experience, she provides an intimate glimpse into her time serving as a combat physician at a trauma hospital in Balad, Iraq during the 2007 military surge. A trained geriatrician and palliative care physician she recounts the stories of several patients that have forever shaped her life and explores the contradictions and ethical challenges she faced while caring for them ultimately struggling with the uncertainty of whether what she was truly doing was good for those she served or herself. [ABSTRACT FROM AUTHOR]

Moral theory is an important guide to bioethical decision-making, but it can confuse and mislead those who offer ethical advice to clinicians and researchers, delaying decisions that must be made in a timely fashion. In this paper I examine the ways moral theory can lead bioethicists astray. Absent a sensitivity to the empirical realities of ethical problems, moral theory 1) contributes to the disappearance of the persons caught in an ethical quandary, 2) focuses on the puzzle-solving rather than examining the conditions that generate moral problems, and 3) universalizes ethical dilemmas, overlooking local processes for resolving moral questions. Taken together, empirically informed moral theory and theoretically informed empirical research can help bioethicists transcend the is/ought problem in ethical work. [ABSTRACT FROM AUTHOR]

The goal of this paper is to articulate and advocate for an enhanced role for philosophers of science in the domain of science policy as well as within the science curriculum. I argue that philosophy of science as a field can learn from the successes as well as the mistakes of bioethics and begin to develop a new model that includes robust contributions to the science classroom, research collaborations with scientists, and a role for public philosophy through involvement in science policy development. Through an analysis of two case studies, I illustrate how philosophers of science can make effective and productive contributions to science education as well as to interdisciplinary scientific research, and argue for the essential role of philosophers of science in the realm of science policy. [ABSTRACT FROM AUTHOR]

Personal autonomy is widely valued. Recognition of its vulnerability in health care contexts led to the inclusion of respect for autonomy as a key concern in biomedical ethics. The principle of respect for autonomy is usually associated with allowing or enabling patients to make their own decisions about which health care interventions they will or will not receive. In this paper, we suggest that a strong focus on decision situations is problematic, especially when combined with a tendency to stress the importance of patients' independence in choosing. It distracts attention from other important aspects of and challenges to autonomy in health care. Relational understandings of autonomy attempt to explain both the positive and negative implications of social relationships for individuals' autonomy. They suggest that many health care practices can affect autonomy by virtue of their effects not only on patients' treatment preferences and choices, but also on their self-identities, self-evaluations and capabilities for autonomy. Relational understandings de-emphasise independence and facilitate well-nuanced distinctions between forms of clinical communication that support and that undermine patients' autonomy. These understandings support recognition of the value of good patient-professional relationships and can enrich the specification of the principle of respect for autonomy. [ABSTRACT FROM AUTHOR]

In this paper, a critique will be developed and an alternative proposed to Luciano Floridi’s approach to Information Ethics (IE). IE is a macroethical theory that is to both serve as a foundation for computer ethics and to guide our overall moral attitude towards the world. The central claims of IE are that everything that exists can be described as an information object, and that all information objects, qua information objects, have intrinsic value and are therefore deserving of moral respect. In my critique of IE, I will argue that Floridi has presented no convincing arguments that everything that exists has some minimal amount of intrinsic value. I will argue, however, that his theory could be salvaged in large part if it were modified from a value-based into a respect-based theory, according to which many (but not all) inanimate things in the world deserve moral respect, not because of intrinsic value, but because of their (potential) extrinsic, instrumental or emotional value for persons. [ABSTRACT FROM AUTHOR]

Preconception sex selection for nonmedical reasons is one of the most controversial issues in bioethics today. The most powerful objection to social sex selection is based on the assumption that it may severely distort the natural sex ratio and lead to a socially disruptive imbalance of the sexes. Based on representative social surveys conducted in Germany, the United Kingdom, and the United States, this paper argues that the fear of an impending sex ratio distortion is unfounded. Given the predominant preference for a "gender balanced family," a widely available service for social sex selection is highly unlikely to upset the balance of the sexes in Western societies. [ABSTRACT FROM AUTHOR]

This paper addresses the integration of the philosophical school of American Pragmatism, as articulated by John Dewey and others, with the disciplines of bioethics and pastoral care. It suggests new avenues for theological reflection in the bioethical enterprise. It was first presented as the inaugural Anton. T. Boisen Lecture in Pastoral Care and Education in 2004 under the auspices of Continuum Hospice Care, New York. [ABSTRACT FROM AUTHOR]

Summary: American bioethics, historically arising out of theology and philosophy, has been dominated by the method of normative analysis. Ethics as policy, however, requires in addition a solid evidence base. This paper discusses the background conditions that make neurotherapeutics research particularly challenging. Three key ethical issues are discussed within an evidence-based ethics framework: the ethical challenges arising from changes in the financial incentive structures for academic researchers and their institutions, the challenges of risk-benefit analysis for neurotherapeutics protocols testing innovative interventions, and the evolving issues surrounding impaired decision-making capacity and surrogate consent for research. For each of these issues, selected empirical data are reviewed, areas for further inquiry are noted, and the need for development of novel methods for bioethics policy research is discussed. [Copyright &y& Elsevier]

The 20th century produced overwhelming advances in biomedicine with the 1990s introducing 148,000 patents as part of the mapping and sequencing of the human genome. Bioethical realities and debates of prenatal genetic testing, new reproductive technologies, stem cell research, human cloning and DNA data banks have obscured the less provocative public and social issues of gun control, immunization, employee leave programs to assist care for dying relatives, emergency room use as primary care sites by the uninsured, and medical care provision to the homeless. With the events of September 11, the focus has shifted to bioterrorism: an international and global concern that portends broad environmental consequences while requiring a local, community response of which the business enterprise is a part. The tension that results from a required local and global response to bioterrorism and biotechnology by the business community forms a dialectic and provides a venue for addressing business ethics in an international forum. This paper explores the relationship of events and its meaning for business. Part I provides the background of biotechnology and bioterrorism and how the two form a dialectic reality that shapes ethical debate. Part II presents provocations and questions for an emerging ethic based on the integrative response from the public health, medical, business and religious communities. Four areas for business contribution in shaping emerging ethics in the age of biotechnology-bioterrorism are suggested. [ABSTRACT FROM AUTHOR]

To date, research regarding the influence of conflicts of interest on the presentation of findings by researchers has been limited. To evaluate the sources of funding for published manuscripts, and association between reported findings and conflicts of interest. Data from both print and electronic issues of The New England Journal of Medicine (NEJM) and The Journal of the American Medical Association (JAMA) were analyzed for sources of funding, areas of investigation, conflict of interest (COI), and presentation of results. We reviewed all original manuscripts published during the year 2001 within NEJM ( N = 193) and JAMA ( N = 205). We use 3 definitions for COI in this paper: a broadly defined criterion, the criterion used by The International Council of Medical Journal Editors (ICMJE), and a criterion defined by the authors. Depending on the COI criteria used, 16.6% to 32.6% of manuscripts had 1 or more author with COI. Based on ICMJE criterion, 38.7% of studies investigating drug treatments had authors with COI. We observed a strong association between those studies whose authors had COI and reported positive findings ( P < .001). When controlling for sample size, study design, and country of primary authors, we observed a strong association between positive results and COI (ICMJE definition) among all treatment studies (adjusted odds ratio [OR], 2.35; 95% confidence interval [CI], 1.08 to 5.09) and drug studies alone (OR, 2.64; 95% CI, 1.09 to 6.39). COI is widespread among the authors of published manuscripts and these authors are more likely to present positive findings. J GEN INTERN MED 2004; 19:51–56. [ABSTRACT FROM AUTHOR]

It has been shown that Very-Low-Voltage and Minimum-Voltage tests can detect defects that escape tests applied at normal voltages. Energy Consumption Ratio test, a recently developed current-based test, has shown its ability to reduce the impact of process variations and detect various types of defects. These tests may be used as supplements to traditional tests to ensure high quality product. In this paper, Very-Low-Voltage, Ultra-Low-Voltage (a modified version of Minimum-Voltage), and Energy Consumption Ratio tests are applied as supplemental tests along with existing traditional tests to a biomedical IC product. The effectiveness and efficiency of these supplemental tests are evaluated and compared with some major traditional tests. The effectiveness analysis indicates that Ultra-Low-Voltage and Energy Consumption Ratio tests identified potentially defective devices from the good devices. The efficiency analysis shows that Energy Consumption Ratio test is much more efficient than Very-Low-Voltage, Ultra-Low-Voltage, and major traditional tests. [ABSTRACT FROM AUTHOR]

Responsibility Without Understanding? How the Debate on the Ethics of Genetic Engineering Depends on Its Philosophy of Science. The main thesis in this paper is that bioethics has no own criteria to judge the chances and risks of genetic engineering. But if we distinguish (1) between different types of genetic, (2) between genetic engineering as a set of methods for experimentation and genetic engineering as an industrial technique and (3) reconstruct the metaphors and the terminology in general, which are used by biologists describing their practice, it is possible to formulate such criteria. As the distinction between nature and culture is the result of human actions (not drawn by nature) and the communication about these actions and distinctions in a given cultural context, the criteria are the result of a discourse, in which not only biologists, but all members of a society argue about the reproduction and structuration of their society. [ABSTRACT FROM AUTHOR]

Health equity is a primary goal of healthcare stakeholders: patients and their advocacy groups, clinicians, other providers and their professional societies, bioethicists, payors and value based care organizations, regulatory agencies, legislators, and creators of artificial intelligence/machine learning (AI/ML)-enabled medical devices. Lack of equitable access to diagnosis and treatment may be improved through new digital health technologies, especially AI/ML, but these may also exacerbate disparities, depending on how bias is addressed. We propose an expanded Total Product Lifecycle (TPLC) framework for healthcare AI/ML, describing the sources and impacts of undesirable bias in AI/ML systems in each phase, how these can be analyzed using appropriate metrics, and how they can be potentially mitigated. The goal of these "Considerations" is to educate stakeholders on how potential AI/ML bias may impact healthcare outcomes and how to identify and mitigate inequities; to initiate a discussion between stakeholders on these issues, in order to ensure health equity along the expanded AI/ML TPLC framework, and ultimately, better health outcomes for all. [ABSTRACT FROM AUTHOR]

With the arrival of new methods of genome editing, especially CRISPR/Cas 9, new perspectives on germline interventions have arisen. Supporters of germ line genome editing (GGE) claim that the procedure could be used as a means of disease prevention. As a possible life-saving therapy, it provides benefits that outweigh its risks. Opponents of GGE claim that the medical and societal risks, especially the use of GGE for genetic enhancement, are too high. In our paper, we analyze the risks and benefits of GGE. We show that the medical risk on an individual level might be reduced by further research in the near future so that they may be outweighed by the benefits. We also show that the societal risks of the procedure, i.e. genetic enhancement, are manageable by establishing a regulative framework before the GGE is implemented. Since the effects of modifying genes for the genepool of a given population are extremely difficult to model, the medical risks on the population level might be too high. [ABSTRACT FROM AUTHOR]

This paper considers the revolutionary developments occurring in the field of genetic mapping and the genetic identification of disease propensities. These breakthroughs are discussed relative to the ethical and economic implications for the insurance industry. Individual's privacy rights and rights to employment must be weighed against the insurers desire for better estimates of future loss costs associated with health, life and other insurances. These are in turn related to the fundamental conception of insurance as a financial intermediary versus insurance as a vehicle for social policy. [ABSTRACT FROM AUTHOR]

Scholars, policymakers and organizations in the EU, especially at the level of the European Commission, have turned their attention to the ethics of (trustworthy and human-centric) Artificial Intelligence (AI). However, there has been little reflexivity on (1) the history of the ethics of AI as an institutionalized phenomenon and (2) the comparison to similar episodes of “ethification” in other fields, to highlight common (unresolved) challenges. Contrary to some mainstream narratives, which stress how the increasing attention to ethical aspects of AI is due to the fast pace and increasing risks of technological developments, Science and Technology Studies(STS)-informed perspectives highlight that the rise of institutionalized assessment methods indicates a need for governments to gain more control of scientific research and to bring EU institutions closer to the public on controversies related to emerging technologies. This article analyzes how different approaches of the recent past (i.e. bioethics, technology assessment (TA) and ethical, legal and social (ELS) research, Responsible Research and Innovation (RRI)) followed one another, often “in the name of ethics”, to address previous criticisms and/or to legitimate certain scientific and technological research programs. The focus is on how a brief history of the institutionalization of these approaches can provide insights into present challenges to the ethics of AI related to methodological issues, mobilization of expertise and public participation. [ABSTRACT FROM AUTHOR]