The Ethics of Population Policy for the Two Worlds of Population Conditions

Population policy has taken two divergent trajectories. In the developing part of the world, controlling population growth has been a major tune of the debate more than a half-century ago. In the more developed part of the world, an inverse pattern results in the discussion over the facilitation of population growth. The ethical debates on population policy have primarily focused on the former and ignored the latter. This paper proposes a more comprehensive account that justifies states' population policy interventions. We first consider the reasons that support pro-natalist policies to enhance fertility rates and argue that these policies are ethically problematic. We then establish an ethics of population policy grounded on account of self-sustaining the body politic, which consists of four criteria: survival, replacement, accountability, and solidarity. We discuss the implications of this account regarding birth-control and pro-natalist policies, as well as non-procreative policies such as immigration, adoption, and unintended baby-saving strategies.

Join the discussion on animal welfare, ethics and rights

A panel of experts will lead a conversation on the concepts of animal welfare, ethics and rights at this year's Animal Welfare Foundation Discussion Forum.

Providing ethics advice in a pandemic, in theory and in practice: A taxonomy of ethics advice

The pandemic significantly raised the stakes for the translation of bioethics insights into policy. The novelty, range and sheer quantity of the ethical problems that needed to be addressed urgently within public policy were unprecedented and required high-bandwidth two-way transfer of insights between academic bioethics and policy. Countries such as the United Kingdom, which do not have a National Ethics Committee, faced particular challenges in how to facilitate this. This paper takes as a case study the brief career of the Ethics Advisory Board (EAB) for the NHS Covid-19 App, which shows both the difficulty and the political complexity of policy-relevant bioethics in a pandemic and how this was exacerbated by the transience and informality of the structures through which ethics advice was delivered. It analyses how and why, after EAB's demise, the Westminster government increasingly sought to either take its ethics advice in private or to evade ethical scrutiny of its policies altogether. In reflecting on EAB, and these later ethics advice contexts, the article provides a novel framework for analysing ethics advice within democracies, defining four idealised stances: the pure ethicist, the advocate, the ethics arbiter and the critical friend.

Lessons for Ethics From the Kingdom of Fungi

This article considers lessons about American (individual-centered) anthropocentric (human-centered) thinking that can be applied to how we confer dignity and moral status to beings other than humans. Interestingly, global bioethics might glean such lessons from fungi.

Permanent Contraception: Ethical Issues and Considerations: ACOG Committee Statement No. 8

Permanent contraception is the most used method of contraception among women aged 15-49 years and is one of the most straightforward surgical procedures an obstetrician-gynecologist can perform. At the same time, this therapeutic option is enormously complex when considered from a historical, sociological, or ethical perspective. This Committee Statement reviews ethical issues related to permanent contraception using a reproductive justice framework. Ethical counseling and shared decision making for permanent contraception should adopt a nonjudgmental, patient-centered approach, using up-to-date information about permanent contraception procedures and alternatives. Obstetrician-gynecologists should strive to avoid bringing into the clinical encounter biases around gender, race, age, and class that affect thoughts on who should or should not become a parent. Obstetrician-gynecologists should also ensure that permanent contraception requests reflect each patient's wishes, come from a desire to permanently end childbearing, and come from a preference for permanent contraception over all reversible methods as well as permanent contraception for the male partner. When difficulties in meeting a postpartum permanent contraception request are anticipated and permanent contraception is desired by the patient, transfer of care for the remainder of pregnancy should be offered. ACOG recognizes the right of all patients to unimpeded access to permanent contraception as a way of ensuring health equity, but it is unclear how to craft policies that protect from coercion but also do not create barriers to autonomously desired care. Determining the ethical balance between access and safeguards will require a collaborative interdisciplinary approach that involves a variety of stakeholders with varying perspectives.

Can One Health Policy Help Us Expand an Ethics of Interconnection and Interdependence?

One Health-a holistic approach to health that brings the moral status of animals and environments into consideration-is understood as a "professional imperative," a value-laden obligation that flows from the scope and objectives of professional roles. In this article, antimicrobial resistance provides a case study to demonstrate the fruitfulness of public health and bioethics collaborations by applying One Health key concepts of interconnection and interdependence. Moving toward an ethics of One Health requires a more nuanced analysis of ecological relationships, including humans' connections to other species as hosts, vectors, domestic companions, meat-eaters' food, and farmers' livelihood.

Disaster solidarity and survivor ethics: a case study of Hurricane María in Puerto Rico

Liminal periods of disaster solidarity in the aftermath of disaster are a common experience of many survivors. These periods have a specifically ethical component in that people spontaneously engage in collective, altruistic action and magnanimously expand their ethical focus beyond normative social distinctions and hierarchies. Inevitably, however, such solidarity seems to wane, and people return to pre-disaster patterns of interaction. Nevertheless, some individuals move beyond opportune acts of assistance to more extensive reorganisations of their lives during the recovery period and reshape their ethical commitments in new and durable directions. These individuals help make visible marginalised 'others' and draw collaborators to share new ethical visions. Based on observational and interview data collected after Hurricane María (2017) in a mountainous Puerto Rican municipality and employing the framework of virtue ethics, this paper examines the differential effects of disaster solidarity on survivors' ethical responses and the different contributions these make to society.

Toward Planetary Health Ethics? Refiguring Bios in Bioethics

In responding to perceived crises-such as the COVID-19 pandemic-in routinized ways, contemporary bioethics can make us prisoners of the proximate. Rather, we need bioethics to recognize and engage with complex configurations of global ecosystem degradation and collapse, thereby showing us paths toward co-inhabiting the planet securely and sustainably. Such a planetary health ethics might draw rewardingly on Indigenous knowledge practices or Indigenous philosophical ecologies. It will require ethicists, with other health professionals, to step up and become public advocates for environmental sustainability. The COVID-19 pandemic should be seen as opening a portal to planetary health ethics or ecologized bioethics.

What can the citations of systematic reviews of ethical literature tell us about their use?-an explorative empirical analysis of 31 reviews

Background

Systematic reviews of ethical literature (SREL) aim at providing an overview of ethical issues, arguments, or concepts on a specific ethical topic. As SREL are becoming more common, their methodology and possible impact are increasingly subjected to critical considerations. Because they analyse and synthetise normative literature, SREL are likely to be used differently than typical systematic reviews. Still, the uses and the expected purposes of SREL were, to date, mainly theoretically discussed. Our explorative study aimed at gaining preliminary empirical insights into the actual uses of SREL.

Methods

Citations of SREL in publications, both scientific and non-scientific, were taken as proxy for SREL uses. The citations of 31 published SREL were systematically searched on Google Scholar. Each citation was qualitatively analysed to determine its function. The resulting categorisation of SREL citations was further quantitatively investigated to unveil possible trends.

Results

The analysis of the resulting sample of SREL citations (n=1812) showed that the selected SREL were mostly cited to support claims about ethical issues, arguments, or concepts, but also to merely mention the existence of literature on a given topic. In this sample, SREL were cited predominantly within empirical publications in journals from various academic fields, indicating a broad, field-independent use of such systematic reviews. The selected SREL were also used as methodological orientations either for the conduct of SREL or for the practical and ethically sensitive conduct of empirical studies.

Conclusions

In our sample, SREL were rarely used to develop guidelines or to derive ethical recommendations, as it is often postulated in the theoretical literature. The findings of this study constitute a valuable preliminary empirical input in the current methodological debate on SREL and could contribute to developing strategies to align expected purposes with actual uses of SREL.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13643-023-02341-y.

Nursing ethics as a distinct entity within bioethics: Implications for clinical ethics practice

The question of whether nursing ethics is a distinct entity within bioethics is an important and thought-provoking one. Though fundamental bioethical principles are appreciated and applied within the practice of nursing ethics, there exist distinct considerations which make nursing ethics a unique subfield of bioethics. In this article, we focus on the importance of relationships as a distinguishing feature of the foundation of nursing ethics, evidenced in its education, practice, and science. Next, we consider two objections to our claim of distinctiveness: first, that nursing ethics is merely an application of bioethical principles; second, that many bioethical subfields emphasize relationships. We respond by highlighting that throughout nursing education and generally in every career path that follows, the creation and nurturing of relationships is emphasized. Compassion and respect for the dignity of every patient is the framework upon which these therapeutic relationships are built. Much of the focus of nursing science rests on creating meaningful interpersonal experiences and human connection. After responding to each objection, we turn to the implications of this distinctiveness on clinical ethics practice, arguing that the strengths of our approach outweigh the limitations. The deep emphasis on creating meaningful interpersonal experiences and human connection supports a greater integration of relationships and social contexts into the evaluation of whether an action is ethically permissible, which is an important benefit in addressing the challenging human situations that patients face. Moreover, this perspective allows nurse ethicists to account for diverse and complex social structures and their influence in making ethical determinations. These strengths outweigh the limitations of potential inconsistencies between nurse and non-nurse clinical ethicists on the same service, a result we attribute to nursing ethics-and, in turn, the practice of the nurse ethicist-being framed by relationships to a larger extent than other bioethical subfields.