BACKGROUND Gastrointestinal endoscopy technology has significantly improved the diagnostic accuracy and the successful treatment of gastrointestinal diseases.However,a series of ethical issues have emerged,such as exp...BACKGROUND Gastrointestinal endoscopy technology has significantly improved the diagnostic accuracy and the successful treatment of gastrointestinal diseases.However,a series of ethical issues have emerged,such as expanding treatment indications,which affect the fair distribution of medical resources.There is limited research on ethical issues in the field of digestive endoscopy.AIM To investigate the level of ethical awareness among gastrointestinal endoscopy practitioners and analyze the ethical issues involved in gastrointestinal endoscopy technology.METHODS A questionnaire survey was performed to collect relevant data(gender,age,degree of education,professional title,personnel category,the level of understanding medical ethical principles,ethics training and its learning pathways)from gastrointestinal endoscopy practitioners at the Second Hospital of Dalian Medical University and Dalian Friendship Hospital,including licensed physicians and nurses(including trainees and graduate students).RESULTS The majority of gastrointestinal endoscopy practitioners have received training on ethics,but there is still considerable room for improvement in their ethical awareness.Different learning pathways may affect the mastery of ethical principles, and understanding of ethical principles is more easily achieved through hospital ethics institutions.CONCLUSIONTo address the ethical issues in gastrointestinal endoscopy technology, it is necessary to enhance the humanisticeducation of gastrointestinal endoscopy practitioners, incorporate ethical standards into the technology assessmentprocess, and establish a patient-centered diagnostic and treatment model to improve the ethical awareness of practitionersand achieve a balance between technology and ethics.展开更多
Background:Medical artificial intelligence(MAI)is a synthesis of medical science and artificial intelligence development,serving as a crucial field in the current advancement and application of AI.In the process of de...Background:Medical artificial intelligence(MAI)is a synthesis of medical science and artificial intelligence development,serving as a crucial field in the current advancement and application of AI.In the process of developing medical AI,there may arise not only legal risks such as infringement of privacy rights and health rights but also ethical risks stemming from violations of the principles of beneficence and non-maleficence.Methods:To effectively address the damages caused by MAI in the future,it is necessary to establish a hierarchical governance system with MAI.This paper examines the systematic collection of local practices in China and the induction and integration of legal remedies for the damage of MAI.Results:To effectively address the ethical and legal challenges of medical artificial intelligence,a hierarchical regulatory system should be established,which based on the impact of intervention measures on natural rights and differences in intervention timing.This paper finally obtains a legal hierarchical governance system corresponding to the ethical risks and legal risks of MAI in China.Conclusion:The Chinese government has formed a multi-agent governance system based on the impact of risks on rights and the timing of legal intervention,which provides a reference for other countries to follow up on the research on MAI risk management.展开更多
Biotechnology policies and regulations must be revised and updated to reflect the most recent advances in plantbreeding technology. New Plant Breeding Techniques(NPBT) such as gene editing have been applied to address...Biotechnology policies and regulations must be revised and updated to reflect the most recent advances in plantbreeding technology. New Plant Breeding Techniques(NPBT) such as gene editing have been applied to address the myriad of challenges in plant breeding, while the use of NPBT as emerging biotechnological tools raises legal and ethical concerns. This study aims to highlight how gene editing is operationalized in the existing literature and examine the critical issues of ethical and legal issues of gene editing for plant breeding. We carried out a systematic literature review(SLR) to provide the current states of ethical and legal discourses surrounding this topic. We also identified critical research priority areas and policy gaps that must be addressed when designing the future governance of gene editing in plant breeding.展开更多
Generative AI,represented by GPT(Generative Pre-trained Transformer),is now leading the technological revolution and is reconstructing the journalism and communication industries'ecosystems because of its powerful...Generative AI,represented by GPT(Generative Pre-trained Transformer),is now leading the technological revolution and is reconstructing the journalism and communication industries'ecosystems because of its powerful generative capacity and diverse range of outputs.While GPT is busy revolutionizing and innovating the production of news content,working patterns,and operation modes,it has also given rise to ethical concerns in regard to news authenticity,data security,humanistic values,and other related aspects.Therefore,it is imperative to initiate strategies and approaches,such as establishing a mechanism for verifying information authenticity,enhancing data security and privacy regulations,and instituting an ethical supervision and governance framework for AI,in order to facilitate the systematic advancement of AI-based news production while reinstating public trust.展开更多
Our study describes the reported rate of the Institutional Review Board(IRB)approval,declaration of Helsinki(DoH),and informed consent in the case reports and case series and investigates factors associated with the e...Our study describes the reported rate of the Institutional Review Board(IRB)approval,declaration of Helsinki(DoH),and informed consent in the case reports and case series and investigates factors associated with the ethical approval report.We searched PubMed for case reports and case series from 2006 to 2017.Annually,we obtained the first 20 articles of a case report cluster from 20 distinct publications.This analysis initially contained at least 2400 papers,with 100 papers each study design and year.Only 26(5.4%)of 480 included studies reported IRB approval,DoH approval,and participant informed consent;58(12.1%)reported two out of three ethical statements(DoH,informed consent,IRB);and 151(31.5%)reported only one,leading to nearly 245 studies(51.0%)did not report any ethical approval item.Both clusters mentioned the DoH the least.Only years,ages,ethical item types,and cluster types were associated with ethical reporting practices.This study found the serious under‐reporting of ethical practices in both case reports and case series.展开更多
This paper is looking at the trends of future medicine focusing on IBM Watson, Microsoft Intelligent Network for Eye care （MINE）, and Google’s AI Eye Doctor. Microsoft’s Mine, an artificial intelligence assistant ...This paper is looking at the trends of future medicine focusing on IBM Watson, Microsoft Intelligent Network for Eye care （MINE）, and Google’s AI Eye Doctor. Microsoft’s Mine, an artificial intelligence assistant program, and Google’s Eye Doctor, were created because of the two characteristics of eye disease. The disease of the eye significantly reduces the quality of human life, but it can be prevented if the illness is discovered in advance. Therefore, prevention of these diseases is important. Through the development of the Google eye Doctor Program shown in the article of “Retinopathy Algorithm”, we obtained the implications for the ethical guidelines that can be applied to other artificial intelligence development programs. At the heart of these guidelines is the efficient and safe treatment of patient illnesses for medical purposes.展开更多
Over the past three decades, genomic and epigenetic sciences have identified more than 70 genes involved in the molecular pathophysiology of Alzheimer’s disease (AD). DNA methylation, abnormal histone and chromatin r...Over the past three decades, genomic and epigenetic sciences have identified more than 70 genes involved in the molecular pathophysiology of Alzheimer’s disease (AD). DNA methylation, abnormal histone and chromatin regulation and the action of various miRNAs induce AD. The identification of mutated genes has paved the way for the development of diagnostic kits and the initiation of gene therapy trials. However, despite major advances in neuroscience research, there is yet no suitable treatment for AD. Therefore, the early diagnosis of this neurodegenerative disease raises several ethical questions, including the balance between the principle of non-maleficence and the principle of beneficence. The aims of this research were to present the genomic and ethical aspects of AD, and to highlight the ethical principles involved in its presymptomatic diagnosis and therapy. A systematic review of the literature in PubMed, Google Scholar and Science Direct was carried out to outline the genomic aspects and ethical principles relating not only to the presymptomatic diagnosis of AD, but also to its gene therapy. A total of 16 publications were selected. AD is a multifactorial disease that can be genetically classified into Sporadic Alzheimer’s Disease and Familial Alzheimer’s Disease based on family history. Gene therapy targeting specific disease-causing genes is a promising therapeutic strategy. Advancements in artificial intelligence applications may enable the prediction of AD onset several years in advance. While early diagnosis of AD may empower patients with full decision competence for early decision-making, it also carries implications for the patient’s family members, who are at risk of developing the disease, potentially becoming a source of confusion or anxiety. AD has a significant impact on the life of individuals at risk and their families. Given the absence of disease modifying therapy, genetic screening and early diagnosis for this condition raise ethical issues that must be carefully considered in the context of fundamental bioethical principles, including autonomy, beneficence, non-maleficence, and justice.展开更多
The systemic view on industry and on production and consumption pattern is an essential feature of the industrial ecology （IE） concept. One consequence of this view is to investigate industrial flows and consumer ac...The systemic view on industry and on production and consumption pattern is an essential feature of the industrial ecology （IE） concept. One consequence of this view is to investigate industrial flows and consumer activities, and their effects on the environment in order to evaluate and eventually optimize these flows with the help of a systems methodology. Industrial ecology has been developed by engineers and natural scientists and its ethical core canon often manifests in anthropocentric assertions such as harmonizing the contradiction between nature and culture with scientific expertise, appropriate technology and socio-economic management. This paper argues however for a biocentric inspired, normative reading of some characteristics of industrial ecology＇s systems methodology. The presumption for the value of this endeavor is that industrial ecology＇s systems methodology has a potential for developing directions for the design of a possible sustainable world.展开更多
Background: Parkinson’s disease (PD) is a complex, multifactorial neurodegenerative disorder with a pathophysiology deriving from the synergy of abnormal aggregation of neuroinflammation, synuclein and dysfunction of...Background: Parkinson’s disease (PD) is a complex, multifactorial neurodegenerative disorder with a pathophysiology deriving from the synergy of abnormal aggregation of neuroinflammation, synuclein and dysfunction of lysosomes, mitochondria and synaptic transport difficulties influenced by genetic and idiopathic factors. Worldwide, PD has a prevalence of 2-3% in people over the age of 65. To date, there is no certified, effective treatment for PD. Aim: The aims of this research were: (i) to present, on the basis of recent advances in molecular genetics and epigenetics, the genomic aspects and challenges of gene therapy trials for PD;(ii) to outline the ethical principles applicable to therapeutic trials for PD. Method: A systematic literature review was carried out to identify relevant articles reporting on genomic aspects and gene therapy in PD from 2001 to October 2023. The search was conducted in French and/or English in three databases: PubMed, Google Scholar and Science Direct. PRISMA guidelines were used in this systematic review. Results: A total of thirty-three publications were selected. An inductive thematic analysis revealed that numerous genetic mutations (SNCA, Parkin, PINK1, DJ-1, LRRK2, ATP13A2, VPS35, Parkin/PRKN, PINK1, DJ1/PARK7) and epigenetic events such as the action of certain miRNAs (miR-7, miR-153, miR-133b, miR-124, miR-137) are responsible for the onset of PD, and that genetic therapy for this pathology raises ethical questions that need to be elucidated in the light of the bioethical principles of autonomy, beneficence, non-maleficence and justice. Conclusion: There is no zero risk in biotechnology. Then, it will be necessary to assess all the potential risks of Parkinson disease’s gene therapy to make the right decision. It is therefore essential to pursue research and, with the guidance of ethics, to advance treatment options and meet the challenges of brain manipulation and its impact on human identity. The golden rule of medicine remains: “Primum non nocere”.展开更多
Background Clinical brain-computer interface(BCI)for mental disorders is an emerging interdisciplinary research field,posing new ethical concerns and challenges,yet lacking practical ethical governance guidelines for ...Background Clinical brain-computer interface(BCI)for mental disorders is an emerging interdisciplinary research field,posing new ethical concerns and challenges,yet lacking practical ethical governance guidelines for stakeholders and the entire community.Aims This study aims to establish a multidisciplinary consensus of principles for ethical governance of clinical BCI research for mental disorders and offer practical ethical guidance to stakeholders involved.Methods A systematic literature review,symposium and roundtable discussions,and a pre-Delphi(round 0)survey were conducted to form the questionnaire for the three-round modified Delphi study.Two rounds of surveys,followed by a third round of independent interviews of 25 experts from BCI-related research domains,were involved.We conducted quantitative analysis of responses and agreements among experts to reveal the consensus and differences regarding the ethical governance of mental BCI research from a multidisciplinary perspective.Results The Delphi panel emphasised important concerns of ethical review practices and ethical principles within the BCI context,identified qualified and highly influential institutions and personnel in conducting and advancing clinical BCI research,and recognised prioritised aspects in the risk-benefit evaluation.Experts expressed diverse opinions on specific ethical concerns,including concerns about invasive technology,its impact on humanity and potential social consequences.Agreement was reached that the practices of ethical governance of clinical BCI for mental disorders should focus on patient voluntariness,autonomy,long-term effects and related assessments of BCI interventions,as well as privacy protection,transparent reporting and ensuring that the research is conducted in qualified institutions with strong data security.Conclusions Ethical governance of clinical research on BCI for mental disorders should include interdisciplinary experts to balance various needs and incorporate the expertise of different stakeholders to avoid serious ethical issues.It requires scientifically grounded approaches,continuous monitoring and interdisciplinary collaboration to ensure evidence-based policies,comprehensive risk assessments and transparency,thereby promoting responsible innovations and protecting patient rights and well-being.展开更多
Introduction: Nursing ethical sensitivity refers to a nurse’s capacity for thoughtful consideration of ethical issues when faced with dilemmas. In the nursing domain, ethical dilemmas arise when nurses face challenge...Introduction: Nursing ethical sensitivity refers to a nurse’s capacity for thoughtful consideration of ethical issues when faced with dilemmas. In the nursing domain, ethical dilemmas arise when nurses face challenges in making sound ethical decisions during clinical practice. These challenges may stem from conflicts between personal values and professional responsibilities. Methodology: Articles downloaded from Pub Med, CNKI, and Google Scholar were reviewed. Results: After rigorous screening, a meticulous analysis was conducted, encompassing 10 articles and involving a substantial cohort of 2863 participants. Existing literature revealed variations in the ethical dilemmas faced by nurses across different departments. The ethical sensitivity of nurses also varies, with higher ethical sensitivity correlating with stronger empathetic abilities. Zhen et al. classified the causes of ethical dilemmas into four main categories: (1) Ethical dilemmas arising from personal reasons of nursing students;(2) Ethical dilemmas stemming from the actions of teachers;(3) Ethical dilemmas triggered by patients;(4) Ethical dilemmas resulting from miscellaneous reasons. Conclusion: According to literature findings, nursing ethical sensitivity was positively linked to the nurse’s ethical decision-making ability. A case study-oriented teaching program has proven effective in enhancing ethical sensitivity among nursing students.展开更多
River ethics,a significant advancement inspired by Chinese President XI Jinping's ecological civilization thought,embodies the philosophical essence of river governance and represents a legacy of innovation by gen...River ethics,a significant advancement inspired by Chinese President XI Jinping's ecological civilization thought,embodies the philosophical essence of river governance and represents a legacy of innovation by generations of water resources professionals.Rooted in river ecology,it offers a framework for advancing modern water governance systems and capabilities.This paper examines eight dimensions of river ethics to provide actionable recommendations:enhancing knowledge systems on water,rivers,and lakes;addressing critical challenges in water governance to strengthen the foundational role of water authorities in ensuring water security,resource management,ecological sustainability and environmental protection;optimizing water project planning to mitigate ecological impacts;ensuring high standards in the lifecycle management of water projects;refining water diversion strategies for precise scheduling;utilizing ecosystem complexity for river and lake restoration;implementing tiered management of water-related disasters;and driving reforms to modernize water governance systems and mechanisms.展开更多
This article explores the ethical considerations surrounding the reporting of offlabel and experimental treatments in medical case reports,with a focus on fields such as oncology,psychiatry,and pediatrics.It emphasize...This article explores the ethical considerations surrounding the reporting of offlabel and experimental treatments in medical case reports,with a focus on fields such as oncology,psychiatry,and pediatrics.It emphasizes the balance between innovation and evidence-based medicine,highlighting the critical role of case reports in disseminating clinical experiences and advancing medical knowledge.The discussion delves into the ethical framework guiding case reporting,including principles of patient autonomy,informed consent,non-maleficence,beneficence,justice,and transparency.Challenges such as negative outcome reporting,commercial interests,and the balance between innovation and caution are examined.Recommendations for ethical vigilance,the development of comprehensive guidelines,and the role of regulatory bodies are proposed to ensure patient safety and uphold scientific integrity.The article concludes by underscoring the importance of a collaborative effort among clinicians,researchers,ethicists,and regulatory bodies to foster the responsible advancement of medical science while adhering to the highest ethical standards.展开更多
Objective:To study the relationship,the mediating effect of organizational commitment on nurses’ethical climate and ethical behavior.Methods:Structural Equation Modeling(SEM)was employed to perform path analysis in t...Objective:To study the relationship,the mediating effect of organizational commitment on nurses’ethical climate and ethical behavior.Methods:Structural Equation Modeling(SEM)was employed to perform path analysis in this exploratory study.The participants consisted of 280 Iranian nurses who were studied through proportional random sampling.The research tool was consisted of(1)the Ethical Climate Questionnaire by Cullen and Victor,which examines the ethical standards of selfishness,philanthropy,and ethical principles,as well as the reference sources of ethical arguments,including individual,regional,and global ones;(2)Allen and Mayer’s questionnaire,which measures organizational commitment in 3 areas:emotional commitment,continuous commitment,and normative commitment;and(3)Peterson’s Ethical Behavior Questionnaire,which combines nine items to form interconnected ethical behaviors and is based on a 5-point Likert scale.The data were analyzed using AMOS and SPSS v.23 software.Results:The correlation coefficient between the two variables,ethical climate and ethical behavior,showed a significant relationship(r=0.10,p=0.085).The organizational commitment showed a significant relationship between some dimensions and the total ethical climate.The ethical climate affects the organizational commitment(beta=3.261)and behavior(beta=0.121).Organizational commitment does not show any significant relationship with ethical behavior.The ethical climate affects the organizational commitment and the ethical behavior.Conclusions:Nursing managers and nursing staff should consider the ethical climate that affects the organizational commitment and nursing ethical behavior.展开更多
This study applies the basic theories of“Ethical Literary Criticism”proposed by Nie Zhenzhao to Arthur Miller’s play All My Sons,focusing on the ethical predicament Joe Keller faces in his specific ethical identity...This study applies the basic theories of“Ethical Literary Criticism”proposed by Nie Zhenzhao to Arthur Miller’s play All My Sons,focusing on the ethical predicament Joe Keller faces in his specific ethical identity within the ethical environment of his time.It further points out the process and the consequence of his ethical choices in the conflict between family interests and social responsibilities,so as to reveal the ethical teaching function of the play.Joe’s ethical predicament arises from the contradiction between his family roles and his desire for interests as a businessman.In this conflict,the interaction of the human factor and the animal factor within the“Sphinx factor”causes Joe to make two different ethical choices.Through Joe’s tragic fate,Miller reveals the ethical enlightenment in All My Sons:Individuals,families,and society are inextricably linked,so today’s citizens need to recognize their inherent social nature and fulfill ethical duties in both personal and social aspects.Miller uses the play to criticize the ethical ethos of 20th-century American society and calls on readers to reevaluate the instrumental rationality behind the American Dream.展开更多
Physical restraint is one of the most controversial methods in managing aggressive behaviors and maintaining patients' safety. This manuscript purposed to convince stockholders and policymakers of the negative imp...Physical restraint is one of the most controversial methods in managing aggressive behaviors and maintaining patients' safety. This manuscript purposed to convince stockholders and policymakers of the negative impact of physical restraint on patients' psychological and physical health. The current authors review the ethical and legal underpinnings of the opponents' and proponents' views. On one hand, there is a clear violation of the main principles of the code of ethics. Autonomy and justice;as the patients are tied against their will and without obtaining their consent, non-maleficent;as physical restraints are reported in many cases of physical and psychological traumas, thus many agencies prohibited the use of physical restraints as a safety method to be replaced with other deescalating techniques. On the other hand, physical restraints are a precious method in controlling aggressive behaviors and maintaining patients' safety, which is the selective beneficence in providing patient care. Also, most of the same agencies who prohibited the use of restraints, agreed the use of physical restraint as the last resor t.Summary statement What is already known about this topic?· Currently, physical restraint is used as the first accessible method to manage patients' behaviors, without considering the negative aura that surrounds the way of treatment. The usage of physical restraint has gone beyond the purpose of maintaining patient safety and managing aggressive behaviors to be a punishment method.· The Ethical and Legal context of using physical restraints is still vague and needs more clarification.What does this paper add?· This manuscript illustrates the Ethical and Legal points of view of the opponents and proponents of using physical restraints.· The current manuscript clearly justifies the authors' point of view to oppose physical restraints usage and how physical restraints violate the core principles of the code of ethics. In addition, it illustrates the legal agencies that suppor t/oppose the usage of physical restraint and the rationale beyond that position.· This manuscript provides alternatives to manage patients' aggressive behaviors and other ways to protect patients' safety as well as patient's dignity and code of ethics.The implications of this paper This argumentative essay provides an accessible, relevant exploration of public health policy, and its impact on nursing practice, mental health services, and patient health. Moreover, it provides a forum for mental health services to evaluate the current implications of physical restraints. The manuscript creates a paradigm for future studies and projects on physical restraints usage.展开更多
This article discusses the manuscript recently published in the World Journal of Gastroenterology,which explores the application of deep learning models in decision-making processes via wireless capsule endoscopy.Inte...This article discusses the manuscript recently published in the World Journal of Gastroenterology,which explores the application of deep learning models in decision-making processes via wireless capsule endoscopy.Integrating artificial intelligence(AI)into gastrointestinal disease diagnosis represents a transformative step toward precision medicine,enhancing real-time accuracy in detecting multi-category lesions at earlier stages,including small bowel lesions and precancerous polyps,ultimately improving patient outcomes.However,the use of AI in clinical settings raises ethical considerations that extend beyond technological potential.Issues of patient privacy,data security,and potential diagnostic biases require careful attention.AI models must prioritize diverse and representative datasets to mitigate inequities and ensure diagnostic accuracy across populations.Furthermore,balancing AI with clinical expertise is crucial,positioning AI as a supportive tool rather than a replacement for physician judgment.Addressing these ethical challenges will support the responsible deployment of AI,through equitable contribution to patient-centered care.展开更多
Objectives:This study aimed to investigate the dual mediating roles of psychological safety and reporting attitudes in the association between ethics-centered leadership and internal whistleblowing among nurses.Method...Objectives:This study aimed to investigate the dual mediating roles of psychological safety and reporting attitudes in the association between ethics-centered leadership and internal whistleblowing among nurses.Methods:A multicenter,cross-sectional study design was employed,involving a convenience sample of 273 nurses among five university hospitals from August to October 2024.Data were collected using a demographic questionnaire,Ethical Leadership Scale,Psychological Safety Scale,Positive Attitudes Toward Whistleblowing Scale,and Internal Whistleblowing Scale.Pearson correlation and structural equation model were conducted to test the hypothesized dual mediation model.Results:The average score of nurses for ethical leadership was 4.14±0.57,psychological safety was 3.80±0.64,reporting attitudes was 4.12±0.67,internal whistleblowing was 3.93±0.52.Ethical leadership had a significant effect on psychological safety(β=0.38,P<0.001),reporting attitudes(β=0.44,P<0.001),and internal whistleblowing(β=0.21,P=0.009).Furthermore,psychological safety(β=0.26,P<0.001)and reporting attitudes(β=0.27,P<0.001)significantly influenced internal whistleblowing among the nurses.The indirect effect of ethics-centered leadership on internal whistleblowing intermediated by psychological safety was significant(β=0.10,P<0.001).Similarly,reporting attitudes demonstrated a significant mediating effect(β=0.12,P=0.003).Conclusions:Ethical leadership encourages internal whistleblowing among nurses by fostering psychological safety and positive reporting attitudes.Therefore,healthcare managers should prioritize ethical leadership development,enhance psychological safety,and foster constructive reporting attitudes that enable nurses to report ethical violations confidently,without apprehension.展开更多
The establishment of a sound science and technology ethics governance system is an inevitable requirement for national modernization.Faced with the development of human gene technology and the chaos in research activi...The establishment of a sound science and technology ethics governance system is an inevitable requirement for national modernization.Faced with the development of human gene technology and the chaos in research activities,the ethical standards and legal positioning of human gene research activities urgently need to be clarified.The human rights ethics view has value inclusiveness and value fundamentality,and includes three levels of connotations:content dimension,relationship dimension,and obligation dimension.It should serve as the ethical standard for human gene research activities.Based on the provisions of China’s Constitution,the human rights ethics view on human gene research,as a constitutional ethics view,can elucidate different levels of rights content,such as human dignity,life and health,and research freedom.It also addresses the weighing of basic rights conflicts and the dual obligation subjects of public and private nature.Relying on the constitutional value embedding of the research ethics view to form ethical consensus,improving ethical review through framework legislation for human rights interests,and implementing ethical responsibility through the human rights-oriented interpretation of ethical legal norms are the three pathways to realizing the human rights ethics view on human gene research.展开更多
Ethical Statements and Participant’s Consents were not included in the published version of the following articles that appeared in previous issues of Allergy Medicine.The appropriate Ethical Statements and Particip...Ethical Statements and Participant’s Consents were not included in the published version of the following articles that appeared in previous issues of Allergy Medicine.The appropriate Ethical Statements and Participant’s Consents provided by the Authors,are included below:“Exploring drug-induced toxic epidermal necrolysis:A case series and comprehensive review”[Allergy Medicine,Volume 3,March 2025,100011]https://doi.org/10.1016/j.allmed.2024.100011 Ethical Statement:This research involves retrospective case analyses using de-identified patient data.There were no prospective interventions,and informed consent has been obtained.展开更多
文摘BACKGROUND Gastrointestinal endoscopy technology has significantly improved the diagnostic accuracy and the successful treatment of gastrointestinal diseases.However,a series of ethical issues have emerged,such as expanding treatment indications,which affect the fair distribution of medical resources.There is limited research on ethical issues in the field of digestive endoscopy.AIM To investigate the level of ethical awareness among gastrointestinal endoscopy practitioners and analyze the ethical issues involved in gastrointestinal endoscopy technology.METHODS A questionnaire survey was performed to collect relevant data(gender,age,degree of education,professional title,personnel category,the level of understanding medical ethical principles,ethics training and its learning pathways)from gastrointestinal endoscopy practitioners at the Second Hospital of Dalian Medical University and Dalian Friendship Hospital,including licensed physicians and nurses(including trainees and graduate students).RESULTS The majority of gastrointestinal endoscopy practitioners have received training on ethics,but there is still considerable room for improvement in their ethical awareness.Different learning pathways may affect the mastery of ethical principles, and understanding of ethical principles is more easily achieved through hospital ethics institutions.CONCLUSIONTo address the ethical issues in gastrointestinal endoscopy technology, it is necessary to enhance the humanisticeducation of gastrointestinal endoscopy practitioners, incorporate ethical standards into the technology assessmentprocess, and establish a patient-centered diagnostic and treatment model to improve the ethical awareness of practitionersand achieve a balance between technology and ethics.
基金funded by China Law Society 2025 Annual Legal Research,Project grant number:CLS(2025)Y04.
文摘Background:Medical artificial intelligence(MAI)is a synthesis of medical science and artificial intelligence development,serving as a crucial field in the current advancement and application of AI.In the process of developing medical AI,there may arise not only legal risks such as infringement of privacy rights and health rights but also ethical risks stemming from violations of the principles of beneficence and non-maleficence.Methods:To effectively address the damages caused by MAI in the future,it is necessary to establish a hierarchical governance system with MAI.This paper examines the systematic collection of local practices in China and the induction and integration of legal remedies for the damage of MAI.Results:To effectively address the ethical and legal challenges of medical artificial intelligence,a hierarchical regulatory system should be established,which based on the impact of intervention measures on natural rights and differences in intervention timing.This paper finally obtains a legal hierarchical governance system corresponding to the ethical risks and legal risks of MAI in China.Conclusion:The Chinese government has formed a multi-agent governance system based on the impact of risks on rights and the timing of legal intervention,which provides a reference for other countries to follow up on the research on MAI risk management.
基金supported by the Ministry of Higher Education(MoHE)Malaysia under the Fundamental Research Grant Scheme(No.FRGS/1/2021/SS0/UM/02/6)the Universiti Malaya Research University Grant(No.RU004A-2020).
文摘Biotechnology policies and regulations must be revised and updated to reflect the most recent advances in plantbreeding technology. New Plant Breeding Techniques(NPBT) such as gene editing have been applied to address the myriad of challenges in plant breeding, while the use of NPBT as emerging biotechnological tools raises legal and ethical concerns. This study aims to highlight how gene editing is operationalized in the existing literature and examine the critical issues of ethical and legal issues of gene editing for plant breeding. We carried out a systematic literature review(SLR) to provide the current states of ethical and legal discourses surrounding this topic. We also identified critical research priority areas and policy gaps that must be addressed when designing the future governance of gene editing in plant breeding.
基金the phased achievement of the subject“Research on Deepening the Construction of‘Smart Chengdu’and Enhancing the Governance Efficiency of Megacities” (2023CS120)a key project under Chengdu’s Philosophy and Social Science Planning Program for 2023。
文摘Generative AI,represented by GPT(Generative Pre-trained Transformer),is now leading the technological revolution and is reconstructing the journalism and communication industries'ecosystems because of its powerful generative capacity and diverse range of outputs.While GPT is busy revolutionizing and innovating the production of news content,working patterns,and operation modes,it has also given rise to ethical concerns in regard to news authenticity,data security,humanistic values,and other related aspects.Therefore,it is imperative to initiate strategies and approaches,such as establishing a mechanism for verifying information authenticity,enhancing data security and privacy regulations,and instituting an ethical supervision and governance framework for AI,in order to facilitate the systematic advancement of AI-based news production while reinstating public trust.
文摘Our study describes the reported rate of the Institutional Review Board(IRB)approval,declaration of Helsinki(DoH),and informed consent in the case reports and case series and investigates factors associated with the ethical approval report.We searched PubMed for case reports and case series from 2006 to 2017.Annually,we obtained the first 20 articles of a case report cluster from 20 distinct publications.This analysis initially contained at least 2400 papers,with 100 papers each study design and year.Only 26(5.4%)of 480 included studies reported IRB approval,DoH approval,and participant informed consent;58(12.1%)reported two out of three ethical statements(DoH,informed consent,IRB);and 151(31.5%)reported only one,leading to nearly 245 studies(51.0%)did not report any ethical approval item.Both clusters mentioned the DoH the least.Only years,ages,ethical item types,and cluster types were associated with ethical reporting practices.This study found the serious under‐reporting of ethical practices in both case reports and case series.
文摘This paper is looking at the trends of future medicine focusing on IBM Watson, Microsoft Intelligent Network for Eye care （MINE）, and Google’s AI Eye Doctor. Microsoft’s Mine, an artificial intelligence assistant program, and Google’s Eye Doctor, were created because of the two characteristics of eye disease. The disease of the eye significantly reduces the quality of human life, but it can be prevented if the illness is discovered in advance. Therefore, prevention of these diseases is important. Through the development of the Google eye Doctor Program shown in the article of “Retinopathy Algorithm”, we obtained the implications for the ethical guidelines that can be applied to other artificial intelligence development programs. At the heart of these guidelines is the efficient and safe treatment of patient illnesses for medical purposes.
文摘Over the past three decades, genomic and epigenetic sciences have identified more than 70 genes involved in the molecular pathophysiology of Alzheimer’s disease (AD). DNA methylation, abnormal histone and chromatin regulation and the action of various miRNAs induce AD. The identification of mutated genes has paved the way for the development of diagnostic kits and the initiation of gene therapy trials. However, despite major advances in neuroscience research, there is yet no suitable treatment for AD. Therefore, the early diagnosis of this neurodegenerative disease raises several ethical questions, including the balance between the principle of non-maleficence and the principle of beneficence. The aims of this research were to present the genomic and ethical aspects of AD, and to highlight the ethical principles involved in its presymptomatic diagnosis and therapy. A systematic review of the literature in PubMed, Google Scholar and Science Direct was carried out to outline the genomic aspects and ethical principles relating not only to the presymptomatic diagnosis of AD, but also to its gene therapy. A total of 16 publications were selected. AD is a multifactorial disease that can be genetically classified into Sporadic Alzheimer’s Disease and Familial Alzheimer’s Disease based on family history. Gene therapy targeting specific disease-causing genes is a promising therapeutic strategy. Advancements in artificial intelligence applications may enable the prediction of AD onset several years in advance. While early diagnosis of AD may empower patients with full decision competence for early decision-making, it also carries implications for the patient’s family members, who are at risk of developing the disease, potentially becoming a source of confusion or anxiety. AD has a significant impact on the life of individuals at risk and their families. Given the absence of disease modifying therapy, genetic screening and early diagnosis for this condition raise ethical issues that must be carefully considered in the context of fundamental bioethical principles, including autonomy, beneficence, non-maleficence, and justice.
文摘The systemic view on industry and on production and consumption pattern is an essential feature of the industrial ecology （IE） concept. One consequence of this view is to investigate industrial flows and consumer activities, and their effects on the environment in order to evaluate and eventually optimize these flows with the help of a systems methodology. Industrial ecology has been developed by engineers and natural scientists and its ethical core canon often manifests in anthropocentric assertions such as harmonizing the contradiction between nature and culture with scientific expertise, appropriate technology and socio-economic management. This paper argues however for a biocentric inspired, normative reading of some characteristics of industrial ecology＇s systems methodology. The presumption for the value of this endeavor is that industrial ecology＇s systems methodology has a potential for developing directions for the design of a possible sustainable world.
文摘Background: Parkinson’s disease (PD) is a complex, multifactorial neurodegenerative disorder with a pathophysiology deriving from the synergy of abnormal aggregation of neuroinflammation, synuclein and dysfunction of lysosomes, mitochondria and synaptic transport difficulties influenced by genetic and idiopathic factors. Worldwide, PD has a prevalence of 2-3% in people over the age of 65. To date, there is no certified, effective treatment for PD. Aim: The aims of this research were: (i) to present, on the basis of recent advances in molecular genetics and epigenetics, the genomic aspects and challenges of gene therapy trials for PD;(ii) to outline the ethical principles applicable to therapeutic trials for PD. Method: A systematic literature review was carried out to identify relevant articles reporting on genomic aspects and gene therapy in PD from 2001 to October 2023. The search was conducted in French and/or English in three databases: PubMed, Google Scholar and Science Direct. PRISMA guidelines were used in this systematic review. Results: A total of thirty-three publications were selected. An inductive thematic analysis revealed that numerous genetic mutations (SNCA, Parkin, PINK1, DJ-1, LRRK2, ATP13A2, VPS35, Parkin/PRKN, PINK1, DJ1/PARK7) and epigenetic events such as the action of certain miRNAs (miR-7, miR-153, miR-133b, miR-124, miR-137) are responsible for the onset of PD, and that genetic therapy for this pathology raises ethical questions that need to be elucidated in the light of the bioethical principles of autonomy, beneficence, non-maleficence and justice. Conclusion: There is no zero risk in biotechnology. Then, it will be necessary to assess all the potential risks of Parkinson disease’s gene therapy to make the right decision. It is therefore essential to pursue research and, with the guidance of ethics, to advance treatment options and meet the challenges of brain manipulation and its impact on human identity. The golden rule of medicine remains: “Primum non nocere”.
基金funded by the Shanghai Philosophy and Social Science Planning Project (2021BZX008)the National Social Science Foundation of China (23BZX110)the National Office for Philosophy and Social Science (20&ZD045).
文摘Background Clinical brain-computer interface(BCI)for mental disorders is an emerging interdisciplinary research field,posing new ethical concerns and challenges,yet lacking practical ethical governance guidelines for stakeholders and the entire community.Aims This study aims to establish a multidisciplinary consensus of principles for ethical governance of clinical BCI research for mental disorders and offer practical ethical guidance to stakeholders involved.Methods A systematic literature review,symposium and roundtable discussions,and a pre-Delphi(round 0)survey were conducted to form the questionnaire for the three-round modified Delphi study.Two rounds of surveys,followed by a third round of independent interviews of 25 experts from BCI-related research domains,were involved.We conducted quantitative analysis of responses and agreements among experts to reveal the consensus and differences regarding the ethical governance of mental BCI research from a multidisciplinary perspective.Results The Delphi panel emphasised important concerns of ethical review practices and ethical principles within the BCI context,identified qualified and highly influential institutions and personnel in conducting and advancing clinical BCI research,and recognised prioritised aspects in the risk-benefit evaluation.Experts expressed diverse opinions on specific ethical concerns,including concerns about invasive technology,its impact on humanity and potential social consequences.Agreement was reached that the practices of ethical governance of clinical BCI for mental disorders should focus on patient voluntariness,autonomy,long-term effects and related assessments of BCI interventions,as well as privacy protection,transparent reporting and ensuring that the research is conducted in qualified institutions with strong data security.Conclusions Ethical governance of clinical research on BCI for mental disorders should include interdisciplinary experts to balance various needs and incorporate the expertise of different stakeholders to avoid serious ethical issues.It requires scientifically grounded approaches,continuous monitoring and interdisciplinary collaboration to ensure evidence-based policies,comprehensive risk assessments and transparency,thereby promoting responsible innovations and protecting patient rights and well-being.
文摘Introduction: Nursing ethical sensitivity refers to a nurse’s capacity for thoughtful consideration of ethical issues when faced with dilemmas. In the nursing domain, ethical dilemmas arise when nurses face challenges in making sound ethical decisions during clinical practice. These challenges may stem from conflicts between personal values and professional responsibilities. Methodology: Articles downloaded from Pub Med, CNKI, and Google Scholar were reviewed. Results: After rigorous screening, a meticulous analysis was conducted, encompassing 10 articles and involving a substantial cohort of 2863 participants. Existing literature revealed variations in the ethical dilemmas faced by nurses across different departments. The ethical sensitivity of nurses also varies, with higher ethical sensitivity correlating with stronger empathetic abilities. Zhen et al. classified the causes of ethical dilemmas into four main categories: (1) Ethical dilemmas arising from personal reasons of nursing students;(2) Ethical dilemmas stemming from the actions of teachers;(3) Ethical dilemmas triggered by patients;(4) Ethical dilemmas resulting from miscellaneous reasons. Conclusion: According to literature findings, nursing ethical sensitivity was positively linked to the nurse’s ethical decision-making ability. A case study-oriented teaching program has proven effective in enhancing ethical sensitivity among nursing students.
基金Three Gorges Follow-up Work Fund,Grant/Award Number:WE0161A042024National Key Research Program of China,Grant/Award Number:2024YFC3210900。
文摘River ethics,a significant advancement inspired by Chinese President XI Jinping's ecological civilization thought,embodies the philosophical essence of river governance and represents a legacy of innovation by generations of water resources professionals.Rooted in river ecology,it offers a framework for advancing modern water governance systems and capabilities.This paper examines eight dimensions of river ethics to provide actionable recommendations:enhancing knowledge systems on water,rivers,and lakes;addressing critical challenges in water governance to strengthen the foundational role of water authorities in ensuring water security,resource management,ecological sustainability and environmental protection;optimizing water project planning to mitigate ecological impacts;ensuring high standards in the lifecycle management of water projects;refining water diversion strategies for precise scheduling;utilizing ecosystem complexity for river and lake restoration;implementing tiered management of water-related disasters;and driving reforms to modernize water governance systems and mechanisms.
文摘This article explores the ethical considerations surrounding the reporting of offlabel and experimental treatments in medical case reports,with a focus on fields such as oncology,psychiatry,and pediatrics.It emphasizes the balance between innovation and evidence-based medicine,highlighting the critical role of case reports in disseminating clinical experiences and advancing medical knowledge.The discussion delves into the ethical framework guiding case reporting,including principles of patient autonomy,informed consent,non-maleficence,beneficence,justice,and transparency.Challenges such as negative outcome reporting,commercial interests,and the balance between innovation and caution are examined.Recommendations for ethical vigilance,the development of comprehensive guidelines,and the role of regulatory bodies are proposed to ensure patient safety and uphold scientific integrity.The article concludes by underscoring the importance of a collaborative effort among clinicians,researchers,ethicists,and regulatory bodies to foster the responsible advancement of medical science while adhering to the highest ethical standards.
基金supported by The Mediating Effect of Organizational Commitment on Nurses’Ethical Climate and Ethical Behavior(No.IR.UMSHA.REC.1396.601).
文摘Objective:To study the relationship,the mediating effect of organizational commitment on nurses’ethical climate and ethical behavior.Methods:Structural Equation Modeling(SEM)was employed to perform path analysis in this exploratory study.The participants consisted of 280 Iranian nurses who were studied through proportional random sampling.The research tool was consisted of(1)the Ethical Climate Questionnaire by Cullen and Victor,which examines the ethical standards of selfishness,philanthropy,and ethical principles,as well as the reference sources of ethical arguments,including individual,regional,and global ones;(2)Allen and Mayer’s questionnaire,which measures organizational commitment in 3 areas:emotional commitment,continuous commitment,and normative commitment;and(3)Peterson’s Ethical Behavior Questionnaire,which combines nine items to form interconnected ethical behaviors and is based on a 5-point Likert scale.The data were analyzed using AMOS and SPSS v.23 software.Results:The correlation coefficient between the two variables,ethical climate and ethical behavior,showed a significant relationship(r=0.10,p=0.085).The organizational commitment showed a significant relationship between some dimensions and the total ethical climate.The ethical climate affects the organizational commitment(beta=3.261)and behavior(beta=0.121).Organizational commitment does not show any significant relationship with ethical behavior.The ethical climate affects the organizational commitment and the ethical behavior.Conclusions:Nursing managers and nursing staff should consider the ethical climate that affects the organizational commitment and nursing ethical behavior.
文摘This study applies the basic theories of“Ethical Literary Criticism”proposed by Nie Zhenzhao to Arthur Miller’s play All My Sons,focusing on the ethical predicament Joe Keller faces in his specific ethical identity within the ethical environment of his time.It further points out the process and the consequence of his ethical choices in the conflict between family interests and social responsibilities,so as to reveal the ethical teaching function of the play.Joe’s ethical predicament arises from the contradiction between his family roles and his desire for interests as a businessman.In this conflict,the interaction of the human factor and the animal factor within the“Sphinx factor”causes Joe to make two different ethical choices.Through Joe’s tragic fate,Miller reveals the ethical enlightenment in All My Sons:Individuals,families,and society are inextricably linked,so today’s citizens need to recognize their inherent social nature and fulfill ethical duties in both personal and social aspects.Miller uses the play to criticize the ethical ethos of 20th-century American society and calls on readers to reevaluate the instrumental rationality behind the American Dream.
文摘Physical restraint is one of the most controversial methods in managing aggressive behaviors and maintaining patients' safety. This manuscript purposed to convince stockholders and policymakers of the negative impact of physical restraint on patients' psychological and physical health. The current authors review the ethical and legal underpinnings of the opponents' and proponents' views. On one hand, there is a clear violation of the main principles of the code of ethics. Autonomy and justice;as the patients are tied against their will and without obtaining their consent, non-maleficent;as physical restraints are reported in many cases of physical and psychological traumas, thus many agencies prohibited the use of physical restraints as a safety method to be replaced with other deescalating techniques. On the other hand, physical restraints are a precious method in controlling aggressive behaviors and maintaining patients' safety, which is the selective beneficence in providing patient care. Also, most of the same agencies who prohibited the use of restraints, agreed the use of physical restraint as the last resor t.Summary statement What is already known about this topic?· Currently, physical restraint is used as the first accessible method to manage patients' behaviors, without considering the negative aura that surrounds the way of treatment. The usage of physical restraint has gone beyond the purpose of maintaining patient safety and managing aggressive behaviors to be a punishment method.· The Ethical and Legal context of using physical restraints is still vague and needs more clarification.What does this paper add?· This manuscript illustrates the Ethical and Legal points of view of the opponents and proponents of using physical restraints.· The current manuscript clearly justifies the authors' point of view to oppose physical restraints usage and how physical restraints violate the core principles of the code of ethics. In addition, it illustrates the legal agencies that suppor t/oppose the usage of physical restraint and the rationale beyond that position.· This manuscript provides alternatives to manage patients' aggressive behaviors and other ways to protect patients' safety as well as patient's dignity and code of ethics.The implications of this paper This argumentative essay provides an accessible, relevant exploration of public health policy, and its impact on nursing practice, mental health services, and patient health. Moreover, it provides a forum for mental health services to evaluate the current implications of physical restraints. The manuscript creates a paradigm for future studies and projects on physical restraints usage.
文摘This article discusses the manuscript recently published in the World Journal of Gastroenterology,which explores the application of deep learning models in decision-making processes via wireless capsule endoscopy.Integrating artificial intelligence(AI)into gastrointestinal disease diagnosis represents a transformative step toward precision medicine,enhancing real-time accuracy in detecting multi-category lesions at earlier stages,including small bowel lesions and precancerous polyps,ultimately improving patient outcomes.However,the use of AI in clinical settings raises ethical considerations that extend beyond technological potential.Issues of patient privacy,data security,and potential diagnostic biases require careful attention.AI models must prioritize diverse and representative datasets to mitigate inequities and ensure diagnostic accuracy across populations.Furthermore,balancing AI with clinical expertise is crucial,positioning AI as a supportive tool rather than a replacement for physician judgment.Addressing these ethical challenges will support the responsible deployment of AI,through equitable contribution to patient-centered care.
文摘Objectives:This study aimed to investigate the dual mediating roles of psychological safety and reporting attitudes in the association between ethics-centered leadership and internal whistleblowing among nurses.Methods:A multicenter,cross-sectional study design was employed,involving a convenience sample of 273 nurses among five university hospitals from August to October 2024.Data were collected using a demographic questionnaire,Ethical Leadership Scale,Psychological Safety Scale,Positive Attitudes Toward Whistleblowing Scale,and Internal Whistleblowing Scale.Pearson correlation and structural equation model were conducted to test the hypothesized dual mediation model.Results:The average score of nurses for ethical leadership was 4.14±0.57,psychological safety was 3.80±0.64,reporting attitudes was 4.12±0.67,internal whistleblowing was 3.93±0.52.Ethical leadership had a significant effect on psychological safety(β=0.38,P<0.001),reporting attitudes(β=0.44,P<0.001),and internal whistleblowing(β=0.21,P=0.009).Furthermore,psychological safety(β=0.26,P<0.001)and reporting attitudes(β=0.27,P<0.001)significantly influenced internal whistleblowing among the nurses.The indirect effect of ethics-centered leadership on internal whistleblowing intermediated by psychological safety was significant(β=0.10,P<0.001).Similarly,reporting attitudes demonstrated a significant mediating effect(β=0.12,P=0.003).Conclusions:Ethical leadership encourages internal whistleblowing among nurses by fostering psychological safety and positive reporting attitudes.Therefore,healthcare managers should prioritize ethical leadership development,enhance psychological safety,and foster constructive reporting attitudes that enable nurses to report ethical violations confidently,without apprehension.
基金This paper is an interim result of“Constitutional Boundaries of the Application of Human Gene Editing Technology,”a Youth Project of the National Social Science Fund of China(Project Approval Number 23CFX040)supported by the“National Funded Programs for Postdoctoral Researchers”(GZC20230937).
文摘The establishment of a sound science and technology ethics governance system is an inevitable requirement for national modernization.Faced with the development of human gene technology and the chaos in research activities,the ethical standards and legal positioning of human gene research activities urgently need to be clarified.The human rights ethics view has value inclusiveness and value fundamentality,and includes three levels of connotations:content dimension,relationship dimension,and obligation dimension.It should serve as the ethical standard for human gene research activities.Based on the provisions of China’s Constitution,the human rights ethics view on human gene research,as a constitutional ethics view,can elucidate different levels of rights content,such as human dignity,life and health,and research freedom.It also addresses the weighing of basic rights conflicts and the dual obligation subjects of public and private nature.Relying on the constitutional value embedding of the research ethics view to form ethical consensus,improving ethical review through framework legislation for human rights interests,and implementing ethical responsibility through the human rights-oriented interpretation of ethical legal norms are the three pathways to realizing the human rights ethics view on human gene research.
文摘Ethical Statements and Participant’s Consents were not included in the published version of the following articles that appeared in previous issues of Allergy Medicine.The appropriate Ethical Statements and Participant’s Consents provided by the Authors,are included below:“Exploring drug-induced toxic epidermal necrolysis:A case series and comprehensive review”[Allergy Medicine,Volume 3,March 2025,100011]https://doi.org/10.1016/j.allmed.2024.100011 Ethical Statement:This research involves retrospective case analyses using de-identified patient data.There were no prospective interventions,and informed consent has been obtained.
