While the technologies that enable Artificial Intelligence (AI) continue to advance rapidly, there are increasing promises regarding AI\'s beneficial outputs and concerns about the challenges of human-computer interaction in healthcare. To address these concerns, institutions have increasingly resorted to publishing AI guidelines for healthcare, aiming to align AI with ethical practices. However, guidelines as a form of written language can be analyzed to recognize the reciprocal links between its textual communication and underlying societal ideas. From this perspective, we conducted a discourse analysis to understand how these guidelines construct, articulate, and frame ethics for AI in healthcare. We included eight guidelines and identified three prevalent and interwoven discourses: (1) AI is unavoidable and desirable; (2) AI needs to be guided with (some forms of) principles (3) trust in AI is instrumental and primary. These discourses signal an over-spillage of technical ideals to AI ethics, such as over-optimism and resulting hyper-criticism. This research provides insights into the underlying ideas present in AI guidelines and how guidelines influence the practice and alignment of AI with ethical, legal, and societal values expected to shape AI in healthcare.

Despite apparent disagreement in the scholarly literature on standards of pediatric decision making, a recognition that similar norms underpin many of the dominant frameworks motivated a June 2022 symposium \"Best Interests and Beyond: Standards of Decision Making in Pediatrics\" in St Louis, MO. Over the course of this 3-day symposium, 17 expert scholars (see author list) deliberated on the question \"In the context of US pediatric care, what moral precepts ought to guide parents and clinicians in medical decision making for children?\" The symposium and subsequent discussion generated 6 consensus recommendations for pediatric decision making, constructed with the primary goals of accessibility, teachability, and feasibility for practicing clinicians, parents, and legal guardians. In this article, we summarize these recommendations, including their justification, limitations, and remaining concerns.

OBJECTIVE: What do people see as distinguishing the morally exceptional from others? To handle the problem that people may disagree about who qualifies as morally exceptional, we asked subjects to select and rate their own examples of morally exceptional, morally average, and immoral people.
METHODS: Subjects rated each selected exemplar on several enablers of moral action and several directions of moral action. By applying the logic underlying stimulus sampling in experimental design, we evaluated perceivers\' level of agreement about the characteristics of the morally exceptional, even though perceivers rated different targets.
RESULTS: Across three studies, there was strong subjective consensus on who is morally exceptional: those who are empathetic and prone to guilt, those who reflect on moral issues and identify with morality, those who have self-control and actually enact moral behaviors, and those who care about harm, compassion, fairness, and honesty. Deep controversies also existed about the moral directions pursued by those seen as morally exceptional: People evaluated those who pursued similar values and made similar decisions more favorably.
CONCLUSIONS: Strong consensus suggests characteristics that may push a person to go beyond normal expectations, that the study of moral exceptionality is not overly hindered by disagreement over who is morally exceptional, and that there is some common ground between disagreeing camps.

Most ethics and research integrity (ERI) training approaches are based on teaching moral rules, duties or responsibilities, often not sufficiently addressing virtue-based ethics. This study aimed to obtain a consensus among relevant experts on the importance of essential virtues for ERI training and their acquisitions. A modified Delphi consensus process was conducted in three rounds; 31 ERI experts participated in Round 1 and 23 in Round 2 and Round 3. Based on findings generated from qualitative data in Round 1, a structured questionnaire with 90 different statements grouped under five domains was developed for Round 2 and Round 3. After the final round, a consensus was achieved on two-thirds of statements included in this study. The experts agreed that virtues are based on learned and reflected attitudes and that the appropriate direction to acquire research virtues is through continuing education using case studies and discussions based on real-life scenarios. Furthermore, the consensus was obtained on 35 scientific virtues that should be stimulated in ERI training, prioritizing honesty, integrity, accountability, criticism and fairness as the most essential scientific virtues for good research practice. These results should be considered in developing or adjusting the ERI training program and materials.

Prompted by recent comments on the moral authority of dialogic consensus, we argue that consensus, specifically dialogic consensus, possesses a unique form of moral authority. Given our multicultural era and its plurality of values, we contend that traditional ethical frameworks or principles derived from them cannot be viewed substantively. Both philosophers and clinicians prioritize the need for a decision to be morally justifiable, and also for the decision to be action-guiding. We argue that, especially against the background of our pluralistic society, it is only via unforced dialogue and properly founded argumentation, aiming for consensus, that we can ascribe rightness or wrongness in a normative fashion to dilemmatic situations. We argue that both the process of dialogue, properly constituted, and the consensual outcome itself have moral authority vested within them. Finally, we argue that the consensual decision made is able to withstand moral scrutiny and is action-guiding, without claiming absolute moral authority in other contexts.

Patient-reported outcomes (PROs) can inform health care decisions, regulatory decisions, and health care policy. They also can be used for audit/benchmarking and monitoring symptoms to provide timely care tailored to individual needs. However, several ethical issues have been raised in relation to PRO use.
To develop international, consensus-based, PRO-specific ethical guidelines for clinical research.
The PRO ethics guidelines were developed following the Enhancing the Quality and Transparency of Health Research (EQUATOR) Network\'s guideline development framework. This included a systematic review of the ethical implications of PROs in clinical research. The databases MEDLINE (Ovid), Embase, AMED, and CINAHL were searched from inception until March 2020. The keywords patient reported outcome* and ethic* were used to search the databases. Two reviewers independently conducted title and abstract screening before full-text screening to determine eligibility. The review was supplemented by the SPIRIT-PRO Extension recommendations for trial protocol. Subsequently, a 2-round international Delphi process (n = 96 participants; May and August 2021) and a consensus meeting (n = 25 international participants; October 2021) were held. Prior to voting, consensus meeting participants were provided with a summary of the Delphi process results and information on whether the items aligned with existing ethical guidance.
Twenty-three items were considered in the first round of the Delphi process: 6 relevant candidate items from the systematic review and 17 additional items drawn from the SPIRIT-PRO Extension. Ninety-six international participants voted on the relevant importance of each item for inclusion in ethical guidelines and 12 additional items were recommended for inclusion in round 2 of the Delphi (35 items in total). Fourteen items were recommended for inclusion at the consensus meeting (n = 25 participants). The final wording of the PRO ethical guidelines was agreed on by consensus meeting participants with input from 6 additional individuals. Included items focused on PRO-specific ethical issues relating to research rationale, objectives, eligibility requirements, PRO concepts and domains, PRO assessment schedules, sample size, PRO data monitoring, barriers to PRO completion, participant acceptability and burden, administration of PRO questionnaires for participants who are unable to self-report PRO data, input on PRO strategy by patient partners or members of the public, avoiding missing data, and dissemination plans.
The PRO ethics guidelines provide recommendations for ethical issues that should be addressed in PRO clinical research. Addressing ethical issues of PRO clinical research has the potential to ensure high-quality PRO data while minimizing participant risk, burden, and harm and protecting participant and researcher welfare.

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The recent development of NBIC technologies has led to the emergence of new techniques that allow the modification of genetic, morphological, and physiological aspects of the human being to improve their capacities. In light of this situation, the eternal debate continues: is everything technically possible ethically acceptable? To answer this question, an ethical reflection is needed to assess the scope of enhancement techniques and to direct them to the service of human progress and the common good. Many authors have already begun this reflection, opting for a case-by-case evaluation. However, there is a great lack of specificity in the definition of the criteria that would allow an ethical analysis of each technique, in order to determine the licitness of its application. In response to this need, a practical guide for the ethical assessment of not only human enhancement techniques, but of any intervention on the human body is proposed. This guide is based on the four principles of personalist bioethics proposed by Sgreccia: the principle of defense of physical human life, the principle of totality or the therapeutic principle, the principle of freedom and responsibility, and the principle of sociability and subsidiarity. These principles are the common thread of some questionnaires that serve as support in discerning the licitness of a technique, by virtue of the overall good of the person in their three-dimensional structure: body, mind and spirit, and the respect for their inalienable dignity.

As COVID-19 cases surge around the world, public health authorities are looking for effective strategies to influence individuals to follow COVID-19 prevention guidelines. However, limited empirical research was conducted to identify the factors behind individuals\' compliance with COVID-19 prevention guidelines. This research proposed an integrated model based on the theory of planned behavior and norm activation theory to explain compliance towards COVID-19 prevention guidelines. Data from a survey of 652 individuals were used to test the proposed integrated model. Results showed that three factors: personal norms, attitude towards compliance- behavior, and perceived behavior control, directly influence compliance with COVID-19 prevention guidelines. Awareness of the risk of the COVID-19 pandemic and feelings of responsibility in the COVID-19 fight drives social and moral obligations, respectively, and also influences compliance behavior. The findings of this study not only contribute to theory development in health compliance behavior but also provide practical guidance to health authorities and policymakers on how to enhance compliance behavior with COVID-19 prevention measures.

This editorial reviews the ethical day-to-day challenges faced by pain specialists when managing each patient\'s unique requirements, in light of guidelines, clinical practice and interpretation of evidence relating to the assessment and management of chronic pain.