Analysis on Current Situation and Ethical Problems of Stem Cell Clinical Research in China / 中国医学伦理学

It is worth pondering how to seek advantages and avoid disadvantages in stem cell clinical research and give full play to the advantages of technology for the benefit of mankind. Through the analysis of the status of stem cell clinical research, including technology and related management methods, proposed the main problems existing in stem cell research, such as the risks of technological uncertainty, ambiguity between research and treatment, over-treatment and technological innovation. Then this paper discussed the ethical and legal risks of stem cell clinical research in China, mainly related to the problems that the construction of laws and regulations is lagging behind, the regulatory challenges of administrative departments are large, the ethical awareness of researchers needs to be further improved, the principle of fairness and justice is not taken into account, the research platform construction of medical institutions is not in place and the protection system of subjects is imperfect, and the organization construction and review capacity of the ethics committee is still lacking.

Ethical Thinking on Fertility Preservation of Female Patients with Cancer / 中国医学伦理学

Fertility preservation technology provides an effective method of protecting fertility resources for young patients with malignant tumors, allowing them to offspring after their fertility is impaired. However, the development of this technology has caused many social and ethical controversies. From the perspective of ethics, this paper discussed the ethical issues faced by young female patients in the implementation of fertility preservation, including whether it is necessary to preserve fertility, the ownership of the preserved fertility resources and the fair and equitable distribution of health resources involved in its implementation process, and identifies these issues and controversies from ethical view. In order to eliminate public doubts and misunderstandings about the technology of fertility preservation, ethical principles of benefit and non-harm, informed consent, prudent application, and ethical supervision have to be followed in the process of providing fertility preservation services, so as to promote the further development and application of fertility preservation technology.

Ethical Issues in the Development of Smart Healthcare / 中国医学伦理学

Smart healthcare is the outcome of integration and application of the internet, Internet of things (IOT), big data analysis and artificial intelligence (AI) in the medical field. Smart healthcare has been developed rapidly in China. However, smart healthcare has both advantages and risks, thus, it faces challenges and ethical issues in practice. Technological restrictions of smart healthcare increase the risk of privacy disclosure and delayed treatment. Besides, it also induce some ethical issues.Smart healthcare turns the "justice" issue of regional equity into the population equity of medical benefits. In addition, balancing between humanities and science technology should be considered. Smart healthcare should follow the basic ethical principles and the experience of clinical medical ethics. To give full play to the advantages of smart healthcare, the ethical challenges during its development must be regulated at the legal level, and simultaneously governed through ethical norms and guidance.

The Ethical Principles of Science and Technology Need Concrete Research to Guide / 中国医学伦理学

On March 20, 2022, the General Office of the CPC Central Committee and the General Office of the State Council issued The Opinions on Strengthening Ethical Governance of Science and Technology, which put forward five ethical principles of science and technology: promoting human well-being, respecting the right to life, adhering to fairness and justice, reasonably controlling risks and maintaining openness and transparency. Ethical principles require to be studied and interpreted concretely by ethical scholars, that is, first, they need to be refined in order to be truly guided; second, the principle of balance is needed to truly guide; third, it is necessary to study ethical theory in order to truly guide; fourth, it is significant to explore Chinese civilization in order to truly guide. In this way, the ethical principles of science and technology can be practically applied and guide the concrete practice of science and technology.

Discrimination of the Governance Principles of Science and Technology Ethics and Dissemination of Ideas / 中国医学伦理学

Ethical governance is inherent in responsible research and innovation. The Opinions on Strengthening Ethical Governance of Science and Technology puts forward five ethical principles: promoting human well-being, respecting the right to life, adhering to fairness and justice, reasonably controlling risks and maintaining openness and transparency. This paper interpreted the ideas, key points and difficulties of these five ethical principles. Three suggestions were put forward to strengthen the ethics education of science and technology: first, optimize the curriculum of science and technology ethics for related majors in colleges and universities, and help young students understand ethical principles and establish the correct ethics view of science and technology; second, colleges and universities should carry out education and training for teachers, researchers, managers and members of ethics committees, and actively explore scientific research ethics training and effect evaluation; third, the professional courses offered by college teachers should be organically integrated with the ideological and political content of the courses to play a warning role.

Ethics in infectious diseases: latent challenges. Part I / Ética en enfermedades infecciosas: retos latentes. Parte I

Abstract Infectious diseases socially imply individual and community medical problems. Therefore, they require actions aimed at social processes that affect the well-being of the individuals without losing sight of social groups. Faced with this panorama, we ask ourselves: is there a direct relationship between ethics and infectious diseases? To elucidate an answer, let us remember the peak period of the COVID-19 pandemic when guidelines based on ethical principles were issued to facilitate medical decisions on allocating scarce resources in periods of maximum demand. In those moments, since there was no inclusive component of society, the decisions made produced massive criticism. The reactions demonstrated the need to analyze in detail the criteria that had been considered correct. Consequently, we affirm that bioethical principles are transcendental in medical decisions and must be examined, not only for the individual but also with a view to public health. Moreover, the acquired immunodeficiency syndrome (AIDS) epidemic has lived with us for decades, and it continues to show its tragic face in the form of new cases, chronic illnesses, and deaths. Joint United Nations Programme on HIV/AIDS brings us closer to a complex reality where the fight against disease and global health are interrelated with other problems, such as the need to reduce inequality, for which human rights, gender equality, social protection, and the development of research projects, where the ethics committees in research in community processes are constituents.

Resumen Las enfermedades infecciosas implican problemas médicos individuales y comunitarios, por lo que requieren acciones dirigidas a procesos sociales que incidan en el bienestar de los individuos, sin perder de vista a los grupos sociales. Nos preguntamos: ¿existe relación directa entre la ética y las enfermedades infecciosas? Para dilucidar una respuesta, recordemos el periodo más álgido de la pandemia por COVID-19, cuando se emitieron guías fundamentadas en principios éticos para facilitar las decisiones médicas en la asignación de recursos escasos en periodos de máxima demanda. Al no haber un componente inclusivo con la sociedad, las decisiones que se tomaron produjeron críticas masivas, que demostraron la necesidad de analizar a detalle los criterios que se habían considerado correctos. En consecuencia, afirmamos que los principios bioéticos son trascendentales en las decisiones médicas y deben ser examinados, no solo frente al individuo, sino de cara a la salud pública (bien común e individualidad). Por otra parte, la epidemia del SIDA (síndrome de inmunodeficiencia adquirida) convive con nosotros desde hace décadas. ONUSIDA (Programa Conjunto de las Naciones Unidas sobre el VIH/SIDA) nos acerca una realidad compleja, como es que la lucha contra la enfermedad y por la salud global se interrelaciona con otros problemas como la necesidad de reducer la desigualdad, por los derechos humanos, la igualdad de género, la protección social y el desarrollo de proyectos de investigación, donde los comités de Ética en investigación en procesos comunitarios son constituyentes.

Challenges and principled responses to privacy protection from biometric technology in China

Biometric technology has transformed human biological characteristics into a new form of privacy, and the misuse of this technology poses challenges to protecting this new privacy. This article initially defines biometric technology and biometric characteristics, further demonstrating why biometric characteristics belong to personal privacy and how biometric technology poses challenges to its protection. Through analysis, this article argues that the essence of these challenges is the conflicts between the ethical principle of privacy protection and the ethical principle of maximizing social benefits. In order to address these challenges, it is necessary first to weigh the fundamental ethical principles. The two basic principles of privacy protection and maximizing social benefits are not mutual antagonism but hierarchy, and this hierarchy should be based on the principle of practical feasibility. That is, applying biometric technology should first meet the principle of practical feasibility and, on this premise, realize the principle of maximizing social benefits based on not infringing on the principle of privacy protection.

La tecnología biométrica ha transformado las características biológicas humanas en una nueva forma de privacidad, y el uso indebido de esta tecnología plantea desafíos a su protección. En este artículo se define inicialmente la tecnología biométrica y las características biométricas; se demuestra además por qué las características biométricas pertenecen a la privacidad personal y cómo la tecnología biométrica plantea retos para su protección. Este artículo argumenta que la esencia de estos retos es el conflicto entre el principio ético de protección de la privacidad y el de maximización de los beneficios sociales. Para abordar estos retos es necesario sopesar primero los principios éticos fundamentales. Los dos principios básicos de protección de la privacidad y maximización de los beneficios sociales no son antagónicos, sino jerárquicos, y esta jerarquía debe basarse en el principio de viabilidad práctica. Es decir, la aplicación de la tecnología biométrica debe cumplir primero el principio de viabilidad práctica y, a partir de esta premisa, realizar el principio de maximización de los beneficios sociales sobre la base de no infringir el principio de protección de la intimidad.

A tecnologia biométrica transformou as características biológicas humanas em uma nova forma de privacidade, e o mal uso dessa tecnologia apresenta desafios para proteger essa nova privacidade. Esse artigo inicialmente define tecnologia biométrica e características biométricas, demonstrando posteriormente por que características biométricas pertencem à privacidade pessoal e como tecnologia biométrica coloca desafios à sua proteção. Através de análise, esse artigo discute que a essência desses desafios é o conflito entre o princípio ético da proteção da privacidade e o princípio ético de maximizar benefícios sociais. De forma a visar esses desafios é necessário primeiro ponderar os princípios éticos fundamentais. Os dois princípios básicos de proteção da privacidade e de maximizar benefícios sociais não são mutuamente antagônicos mas hierárquicos, e essa hierarquia deve ser baseada no princípio da viabilidade prática. Isso é, aplicar tecnologia biométrica deve primeiro atender ao princípio da viabilidade prática e, nessa premissa, compreender o princípio de maximizar benefícios sociais com base em não infringir o princípio de proteção da privacidade.

Argumentación ética en la donación de riñón de donante vivo y sano La autodeterminación, voluntad y generosidad superan los riesgos

el gesto altruista del donante vivo y sano de riñón, relacionado genética o sentimentalmente, se basa en autodeterminación, voluntad y generosidad. La argumentación ética alrededor de la donación de riñón de donante vivo y sano se orienta con las éticas principialista y personalista, la dignidad humana, la corporalidad, la divisibilidad del cuerpo, el mal menor y el mal mayor. Hace parte del derecho a la información amplia y suficiente que recibe el donante sobre los riesgos y posibles complicaciones físicas y morales del procedimiento, por medio del comité de bioética y el grupo de trasplantes. Con base en la argumentación ética planteada se procedió a contestar la pregunta de esta investigación: ¿se debe dejar que una persona viva y sana sea sometida a una cirugía que le dejará mononéfrico de por vida, solo por el deseo de ayudar a otro, a pesar de que existen programas activos con donante cadavérico? El objetivo de este artículo es plantear una argumentación ética sobre la donación de riñón de donante vivo y sano que contribuya a una adecuada orientación de su decisión.

the altruistic gesture of the healthy living kidney donor, genetically or sentimentally related, is based on self-determination, willingness, and generosity. The ethical argumentation around living and healthy kidney donation is guided by principled and personalistic ethics, human dignity, corporeality, divisibility of the body, the lesser evil, and the greater evil. It is part of the right to ample and sufficient information that the donor receives about the procedure's risks and possible physical and moral complications through the bioethics committee and the transplant group. Based on the ethical argumentation raised, we proceeded to answer the question of this research: should a living and healthy person be subjected to a surgery that will leave him/her mononephric for life, just because of the desire to help another, even though there are active programs with a cadaveric donor? This article aims to provide an ethical argumentation on living and healthy donor kidney donation that will contribute to an adequate orientation of their decision.

o gesto altruísta do doador de rim vivo e saudável, relacionado genética ou sentimentalmente, está baseado na autodeterminação, vontade e generosidade. A argumentação ética ao redor da doação de rim de doador vivo e saudável é orientada pelas éticas principialista e personalista, pela dignidade humana, pela corporalidade, pela divisibilidade do corpo, pelo mal menor e pelo mal maior. Faz parte do direito à informação ampla e suficiente que o doador recebe sobre os riscos e possíveis complicações físicas e morais do procedimento, por meio do comitê de bioética e do grupo de transplantes. Com base na argumentação ética proposta, procedeu-se a contestar a seguinte pergunta de pesquisa: deve-se deixar que uma pessoa viva e saudável seja submetida a uma cirurgia que a deixará mononéfrico para sempre, somente pelo desejo de ajudar o outro, apesar de existirem programas ativos com doador cadavérico? Nesse contexto, o objetivo deste artigo é apresentar uma argumentação ética sobre a doação de rim de doador vivo e saudável que contribua para uma adequada orientação de sua decisão.

Ethical Disputes and Norms of Exposure Therapy / 中国医学伦理学

Exposure therapy is a kind of behavior therapy that exposes patients to certain stimulating situations to make them tolerate and adapt. Based on the ethical perspective, this paper introduced the ethical disputes in exposure therapy from three aspects that safety and tolerance, patient rights and humanistic care, as well as professional ethics and moral risks of psychotherapists. This paper also put forward three ethical norms and requirements, including earnestly implementing the principle of informed consent, adhering to the principle of no harm in the whole process, and obeying the principle of confidentiality, in order to improve the professional level of exposure therapy and protect the rights and interests of patients and psychotherapists.

Ethics Considerations on Public Management of Disaster Rescue under the Context of Epidemic Prevention and Control / 中国医学伦理学

Natural disasters and epidemics are intertwined, posing a great threat to national health and property security, and hindering economic development. Faced with the complex rescue environment, the contradiction between individual interests and collective interests may escalate, causing ethical dilemmas different from those encountered in conventional medicine. In the context of COVID-19 epidemic prevention and control, how to maximize the coordination of the conflict between individual interests and collective interests, minimize the losses caused by disasters, and maintain social stability is a new topic of ethical research. Based on the ethical principles of public management, this paper explored the ethical conflicts of public management faced by emergency disaster rescue, in the view of providing ethical theoretical support for dealing with the practical difficulties of emergency public health crisis, and promoting the development and progress of disaster medical rescue work.

Current Status and Ethical Considerations of Data Collection and Application in Rare Disease Research / 中国医学伦理学

The research on rare diseases in China started relatively late, with scattered research resources and weak data foundation in epidemiology, diagnosis and treatment, and medication, which hinders its research progress. The rare disease data system is the foundation of rare disease research, and the ethical constraint on rare disease data collection is not only the protection of rare disease population, but also the need for the safety and quality of rare disease data. By analyzing and prospecting the current status of the construction of rare disease data systems, including the data of epidemiology, clinical diagnosis and treatment, drug trials, and follow-up to provide reference for the improvement of rare disease data systems. This paper explored the ethical issues to be followed in the process of rare disease data collection from the perspectives of justice, no harm, respect, sharing, and legalization, so as to improve the standardization of rare disease data collection and the understanding of data ethical review.

Analysis on the Ethical Principles of Traditional Chinese Medicine Health Preservation Thought from the Perspective of Healthy China: Taking Master Lyu’s Spring and Autumn Annals as an Example / 中国医学伦理学

"Healthy China 2030" states that health is a necessary requirement for all-round human development and a basic condition for economic and social development. Achieving national health and longevity is an important symbol of national prosperity and rejuvenation, and also the common aspiration of the people of all ethnic groups in China. Traditional Chinese medicine (TCM) health preservation has been fully integrated into the construction of "Healthy China", and the development of TCM health preservation culture and thought has a profound historical origin. Starting from the development of TCM health preservation culture thought and ethical principles, this paper analyzed the TCM health preservation thought contained in Master Lyu’s Spring and Autumn Annals, and further discussed and summarized the ethical principles contained in them, with a view to comprehensively and systematically promoting the development of TCM health preservation culture and providing a theoretical basis for people to use health preservation ethical principles to achieve physical fitness, disease prevention and longevity.

Criminologia crítica e princípios éticos do Serviço Social: uma aproximação à sua interlocução / Critical criminology and Social Work ethical principles: an approach to their interlocution

Resumo: Este artigo objetiva trazer a importância da criminologia crítica como subsídio ao trabalho e à formação profissional, apresentando seus fundamentos numa análise marxista, levando em consideração a classe, a raça e o gênero, e sua possível interlocução com os princípios éticos do Serviço Social, vislumbrando uma aproximação maior com essa perspectiva na luta anticapitalista, antirracista, feminista e antipunitivista.

Abstract: This article aims to bring the importance of critical criminology as a subsidy to professional work and professional education, presenting its foundations in a Marxist analysis, taking class, race, and gender into consideration, and its possible interlocution with the ethical principles of Social Work, aiming at a greater approximation with this perspective in the anti-capitalist, anti-racist, feminist, and anti-punitivist fight.

Ethical aspects of age estimation for forensic purposes in Saudi Arabia / Aspectos éticos de la estimación de la edad para propósitos forenses en Arabia Saudita / Aspectos éticos da estimativa de idade para propósitos forenses na Arábia Saudita

Abstract: In forensic and legal contexts, an assessment of skeletal maturation is required to predict the chronological age in certain circumstances in which the chronological age is undocumented or unable to be proven. Carrying such medical examinations will always pose an ethical concern, especially in cases of assessing sexual maturity as well as examinations involving ionizing radiation. The cultural and religious barriers are also discussed concerning the ethical standards set in Saudi Arabia. Several ethical issues concerning age estimation examinations including issues related to consent forms, privacy, and radiation hazards have been documented. While ethical issues regarding radiation hazards are more likely to be overcome by introducing other imaging modalities without radiation hazards, ethics related to consent forms and privacy are still to be improved.

Resumen: En contextos forenses y legales, se requiere la evaluación de la maduración del esqueleto para predecir la edad cronológica en ciertas circunstancias en que la edad cronológica no está documentada o no es posible de probar. Realizar tales exámenes médicos siempre significa una preocupación ética, especialmente en casos de evaluación de madurez sexual así como en exámenes que involucran radiaciones ionizantes. Se discuten también las barreras culturales y religiosas relacionadas con el contexto de estándares éticos en Arabia Saudita. Entre los varios temas éticos relacionados con la estimación de la edad, se documentan temas relacionados con los formularios de consentimiento, privacidad y riesgos de radiación. Mientras que los temas éticos relacionados con riesgos de radiación pueden ser resueltos al introducir otras modalidades de examen sin radiación, los problemas éticos relacionados con los formularios de consentimiento y privacidad todavía necesitan mejorarse.

Resumo: Em contextos forenses e legais, uma avaliação de maturação esquelética é requerida para predizer a idade cronológica em certas circunstâncias nas quais a idade cronológica não é documentada ou impossível de ser provada. Conduzir tais exames médicos sempre irá suscitar uma preocupação ética, especialmente em casos para avaliar maturidade sexual bem como exames envolvendo radiação ionizante. As barreiras culturais e religiosas também são discutidas no que diz respeito a padrões éticos estabelecidos na Arábia Saudita. Diversos aspectos éticos concernentes a exames de estimativa de idade incluindo aspectos relacionados a formulários de consentimento, privacidade e risco de radiação foram documentados. Ao passo que aspectos éticos que dizem respeito a risco de radiação serem mais provavelmente superáveis pela introdução de outras modalidades de exames de imagem sem risco de radiação, a ética relacionada a formulários de consentimento e privacidade ainda estão por serem melhorados.

The Ethical Principles of Science and Technology Need Concrete Research to Guide / 中国医学伦理学

On March 20, 2022, the General Office of the CPC Central Committee and the General Office of the State Council issued The Opinions on Strengthening Ethical Governance of Science and Technology, which put forward five ethical principles of science and technology: promoting human well-being, respecting the right to life, adhering to fairness and justice, reasonably controlling risks and maintaining openness and transparency. Ethical principles require to be studied and interpreted concretely by ethical scholars, that is, first, they need to be refined in order to be truly guided; second, the principle of balance is needed to truly guide; third, it is necessary to study ethical theory in order to truly guide; fourth, it is significant to explore Chinese civilization in order to truly guide. In this way, the ethical principles of science and technology can be practically applied and guide the concrete practice of science and technology.

Discrimination of the Governance Principles of Science and Technology Ethics and Dissemination of Ideas / 中国医学伦理学

Ethical governance is inherent in responsible research and innovation. The Opinions on Strengthening Ethical Governance of Science and Technology puts forward five ethical principles: promoting human well-being, respecting the right to life, adhering to fairness and justice, reasonably controlling risks and maintaining openness and transparency. This paper interpreted the ideas, key points and difficulties of these five ethical principles. Three suggestions were put forward to strengthen the ethics education of science and technology: first, optimize the curriculum of science and technology ethics for related majors in colleges and universities, and help young students understand ethical principles and establish the correct ethics view of science and technology; second, colleges and universities should carry out education and training for teachers, researchers, managers and members of ethics committees, and actively explore scientific research ethics training and effect evaluation; third, the professional courses offered by college teachers should be organically integrated with the ideological and political content of the courses to play a warning role.

Ethical Issues in the Development of Smart Healthcare / 中国医学伦理学

Smart healthcare is the outcome of integration and application of the internet, Internet of things (IOT), big data analysis and artificial intelligence (AI) in the medical field. Smart healthcare has been developed rapidly in China. However, smart healthcare has both advantages and risks, thus, it faces challenges and ethical issues in practice. Technological restrictions of smart healthcare increase the risk of privacy disclosure and delayed treatment. Besides, it also induce some ethical issues.Smart healthcare turns the "justice" issue of regional equity into the population equity of medical benefits. In addition, balancing between humanities and science technology should be considered. Smart healthcare should follow the basic ethical principles and the experience of clinical medical ethics. To give full play to the advantages of smart healthcare, the ethical challenges during its development must be regulated at the legal level, and simultaneously governed through ethical norms and guidance.

Analysis on Current Situation and Ethical Problems of Stem Cell Clinical Research in China / 中国医学伦理学

It is worth pondering how to seek advantages and avoid disadvantages in stem cell clinical research and give full play to the advantages of technology for the benefit of mankind. Through the analysis of the status of stem cell clinical research, including technology and related management methods, proposed the main problems existing in stem cell research, such as the risks of technological uncertainty, ambiguity between research and treatment, over-treatment and technological innovation. Then this paper discussed the ethical and legal risks of stem cell clinical research in China, mainly related to the problems that the construction of laws and regulations is lagging behind, the regulatory challenges of administrative departments are large, the ethical awareness of researchers needs to be further improved, the principle of fairness and justice is not taken into account, the research platform construction of medical institutions is not in place and the protection system of subjects is imperfect, and the organization construction and review capacity of the ethics committee is still lacking.

Ethical Thinking on Fertility Preservation of Female Patients with Cancer / 中国医学伦理学

Fertility preservation technology provides an effective method of protecting fertility resources for young patients with malignant tumors, allowing them to offspring after their fertility is impaired. However, the development of this technology has caused many social and ethical controversies. From the perspective of ethics, this paper discussed the ethical issues faced by young female patients in the implementation of fertility preservation, including whether it is necessary to preserve fertility, the ownership of the preserved fertility resources and the fair and equitable distribution of health resources involved in its implementation process, and identifies these issues and controversies from ethical view. In order to eliminate public doubts and misunderstandings about the technology of fertility preservation, ethical principles of benefit and non-harm, informed consent, prudent application, and ethical supervision have to be followed in the process of providing fertility preservation services, so as to promote the further development and application of fertility preservation technology.

Reflection on the Relationship between the Ethical Principles and Rules of Biomedical Science and Technology / 中国医学伦理学

Clarifying the relationship between ethical principles and rules is the key to promote the legitimate governance of scientific and technological ethics. Ethical principles and rules, as the two basic elements of science and technology ethics, are both different and related. The ethical principles are the basis and direction of the formulation of the ethical rules which are the most direct expression of following the ethical principles and an effective means to improve the effect of ethical governance. Among them, ethical standards are the general standard rules with strong universality. Based on the analysis of the relationship between the ethical principles and the ethical guidelines, this paper put forward the expression mode and reasonable application of science and technology ethical principles in the ethical rules, so as to promote the improvement of the national ethics governance system of biomedical science and technology.