Journal of Bioethical Enquiry

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Commentary: The Voice of the People, Funded Now by Your Friendly Pharmaceutical Company

Mon, 2020-03-23 22:00
AbstractPharmaceutical industry funding has transformed much grassroots community activism on health into corporate-sponsored advocacy. This critical commentary outlines recent evidence about industry funding of patient advocacy groups, offers a commentary on the history of grassroots activism appearing in this issue of the journal, and calls for greater scrutiny of the impacts and ethics of such sponsorship. (Source: Journal of Bioethical Inquiry)
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Telling, Hearing, and Believing: A Critical Analysis of Narrative Bioethics

Sun, 2020-03-15 22:00
AbstractNarrative ethics taps into an inherent human need to tell our own stories centred on our own moral values and to have those stories heard and acknowledged. However, not everyone ’s words are afforded equal power. The use of narrative ethics in bioethical decision-making is problematized by a disparity in whose stories are told, whose stories are heard, and whose stories are believed. Here, I conduct an analysis of narrative ethics through a critical theory lens to show ho w entrenched patterns of narrative neglect in medicine are harming not only our capacity to make use of narrative ethics but also our capacity to deliver effective healthcare. To illustrate this point, I use three examples where the patient’s gender affects how their stories unfold: autism, weight , and pain m...
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Status, Respect, and Stigma: A Qualitative Study of Non-financial Interests in Medicine

Tue, 2020-03-10 22:00
AbstractConflicts of interest (COI) in health and medicine have been the source of considerable public and professional debate. Much of this debate has focused on financial, rather than non-financial COI, which is a significant lacuna because non-financial COI can be just as influential as financial COI. In an effort to explore the nature and effects of non-financial, as well as financial COI, we conducted semi-structured interviews with eleven Australian medical professionals regarding their experiences of, and attitudes towards, COI. We found that this group of medical professionals saw non-financial interests —most notably the pursuit of status and respect and the avoidance of stigma—as potentially conflicting with other important interests (such as patient care). (Source: Journal o...
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After Conflicts of Interest: From Procedural Short-Cut to Ethico-Political Debate

Tue, 2020-03-10 22:00
AbstractThis paper critically examines the proliferation of conflicts of interest (COI) discourse and how the most common conceptions of COI presuppose a hierarchy of primary and secondary interests. I show that a form of professional virtue or duty is commonly employed to give the primary interest normative force. However, I argue that in the context of increasingly commercialized healthcare neither virtue nor duty can do the normative work expected of them. Furthermore, I suggest that COI discourse is symptom of rather than solution to the problems of market forces in contemporary medicine. I contend that COI, as it is commonly conceived, is an inadequate concept through which to attend to these problems. It is used as a procedural short-cut to address ethico-political problems. That is,...
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Genome Editing for Longer Lives: The Problem of Loneliness

Sun, 2020-03-08 22:00
AbstractThe development of gene-editing technologies, such as the clustered regularly interspaced short palindromic repeats and associated Cas9 endonuclease (CRISPR/Cas9) system, coincides with a rapidly expanding knowledge of the role of genes in the human ageing process. This raises the prospect that, in addition to the treatment of genetic diseases and disorders, it may become possible to use gene-editing technologies to alter the ageing process and significantly extend the maximum human lifespan. Germline editing poses distinctive problems due to its implications for individual members of future, unborn generations. In this essay, I wish to home in, narrowly, on a single ethical objection to extending the lifespan of future generations by editing the human germline. The objection sugge...
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A Continent Aflame: Ethical Lessons From the Australian Bushfire Disaster

Sun, 2020-03-08 22:00
(Source: Journal of Bioethical Inquiry)
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Human Dignity and Gene Editing: Additional Support for Raposo ’s Arguments

Sun, 2020-03-08 22:00
This article offers some complementary ideas supporting her statement. In particular, four main arguments are stressed. Firstly, not only is the idea of human dignity unclear, but the idea of the human genome suffers from a general lack of concreteness, which has dramatic consequences for the debate. Secondly, it is highlighted that if we believe that the immutability of the human genome underpins human dignity, then it should be our duty to use the tools of genetic modification to reverse any accidental changes that occur in nature. Thirdly, it is showed that if the alteration of germline constitutes an attack on human dignity, then we should also refrain from performing medical practices such as chemotherapy, which cause precisely this effect. Finally, we argue that modification of germl...
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Formulating an Ethics of Pharmaceutical Disinvestment

Tue, 2020-03-03 22:00
AbstractThere is growing interest among pharmaceutical policymakers in how to “disinvest” from subsidized medicines. This is due to both the rapidly rising costs of healthcare and the increasing use of accelerated and conditional reimbursement pathways which mean that medicines are being subsidized on the basis of less robust evidence of safety and efficacy. It is crucial that disinvestment decisions are morally sound and socially legitimate, but there is currently no framework to facilitate this. We therefore reviewed the bioethics literature in order to identify ethical principles and concepts that might be relevant to pharmaceutical disinvestment decisions. This revealed a number of key ethical considerations—both procedural and substantive—that need to be considered when making...
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Lead Essay: Money, Equity and Access to Medicines

Sun, 2020-03-01 22:00
(Source: Journal of Bioethical Inquiry)
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