Background The principles of dynamic consent are based on the idea of safeguarding the autonomy of individuals by providing them with personalized options to choose from regarding the sharing and utilization of personal health data. To facilitate the widespread introduction of dynamic consent concepts in practice, individuals must perceive these procedures as useful and easy to use. This study examines the user experience of a dynamic consent-based application, in particular focusing on personalized options, and explores whether this approach may be (...) useful in terms of ensuring the autonomy of data subjects in personal health data usage. Methods This study investigated the user experience of MyHealthHub, a dynamic consent-based application, among adults aged 18 years or older living in South Korea. Eight tasks exploring the primary aspects of dynamic consent principles–including providing consent, monitoring consent history, and managing personalized options were provided to participants. Feedback on the experiences of testing MyHealthHub was gathered via multiple-choice and open-ended questionnaire items. Results A total of 30 participants provided dynamic consent through the MyHealthHub application. Most participants successfully completed all the provided tasks without assistance and regarded the personalized options favourably. Concerns about the security and reliability of the digital-based consent system were raised, in contrast to positive responses elicited in other aspects, such as perceived usefulness and ease of use. Conclusions Dynamic consent is an ethically advantageous approach for the sharing and utilization of personal health data. Personalized options have the potential to serve as pragmatic safeguards for the autonomy of individuals in the sharing and utilization of personal health data. Incorporating the principles of dynamic consent into real-world scenarios requires remaining issues, such as the need for powerful authentication mechanisms that bolster privacy and security, to be addressed. This would enhance the trustworthiness of dynamic consent-based applications while preserving their ethical advantages. (shrink)

Background Conventional consent practices face ethical challenges in continuously evolving digital health environments due to their static, one-time nature. Dynamic consent offers a promising solution, providing adaptability and flexibility to address these ethical concerns. However, due to the immaturity of the concept and accompanying technology, dynamic consent has not yet been widely used in practice. This study aims to identify the facilitators of and barriers to adopting dynamic consent in real-world scenarios. Methods This scoping review, conducted in December 2022, adhered (...) to the PRISMA Extension for Scoping Reviews guidelines, focusing on dynamic consent within the health domain. A comprehensive search across Web of Science, PubMed, and Scopus yielded 22 selected articles based on predefined inclusion and exclusion criteria. Results The facilitators for the adoption of dynamic consent in digital health ecosystems were the provision of multiple consent modalities, personalized alternatives, continuous communication, and the dissemination of up-to-date information. Nevertheless, several barriers, such as consent fatigue, the digital divide, complexities in system implementation, and privacy and security concerns, needed to be addressed. This study also investigated current technological advancements and suggested considerations for further research aimed at resolving the remaining challenges surrounding dynamic consent. Conclusions Dynamic consent emerges as an ethically advantageous method for digital health ecosystems, driven by its adaptability and support for continuous, two-way communication between data subjects and consumers. Ethical implementation in real-world settings requires the development of a robust technical framework capable of accommodating the diverse needs of stakeholders, thereby ensuring ethical integrity and data privacy in the evolving digital health landscape. (shrink)

Mental health is a kind of emotional state, a good psychological state can have a positive impact on a person, physical exercise can have a positive impact on the psychological state of college students, prevent the generation of negative emotions, improve the bad emotional state, and then promote the mental health of college students. Health is an inevitable requirement to promote the all-round development of people and a basic condition for economic and social development. Health education should be incorporated into (...) the national education system to promote the national health of the people through sports. Young people are the main force and backbone of national and social development. In order to realize the Chinese dream of great rejuvenation, we must attach importance to the development of young people and the physical and mental health of young people. In the process of compulsory education, middle school and high school period is a key stage in the gradual formation and development of students' psychology and body, but due to the large audience of China's education, the competition is more intense, which inevitably causes a lot of students to focus on exam-oriented education and neglect physical health, especially in recent years, the mental health issues of increasing concern. Through the research situation of mental health in China and the concept of mental health quality, this paper analyzes the problems of sports and mental health, and puts forward some corresponding suggestions for the problems, which has reference significance for promoting students' mental health. (shrink)

ObjectivesHostile attribution bias is reportedly common from non-clinical population to those with serious mental illness, such as schizophrenia, and is known to be closely related to theory of mind. This study aimed to investigate whether ToM skills mediate the relationship among neurocognitive ability, personality traits, and attribution bias.MethodsA total of 198 non-clinical youths were recruited. To assess their neurocognitive ability and ToM skills, the participants were asked to complete Raven’s Standard Progressive Matrices and the Korean version of the Reading the (...) Mind in Eyes Test. To determine their personality traits, the Eysenck Personality Questionnaire and interpersonal reactivity index were used. To evaluate hostile attribution bias, the Ambiguous Intentions Hostility Questionnaire was administered. Path analysis and bias-corrected percentile bootstrap methods were used to estimate model fit and the parameters of the mediating effects.ResultsBased on model comparison, the best model characterized two direct pathways from psychoticism and the K-RMET to hostility attribution bias and three indirect pathways, wherein SPM, perspective taking, and psychoticism influenced hostile attribution bias through K-RMET. The final model fit indices were good [x2/df = 1.126; comparative fit index = 0.996; root mean square error of approximation = 0.026; standard root mean square residual = 0.026 and Akaike information criterion = 28.251] and the K-RMET fully mediated the association between SPM, perspective taking, psychoticism, and hostile attribution bias.ConclusionThe main findings suggested that ToM skills, such as the RMET, play an important role in explaining the relationship among neurocognitive ability, personality traits, and hostile attribution bias. ToM skills and a remediation strategy may need to be developed to balance the enhanced hostility bias that underlies the paranoia. (shrink)

East Asian countries such as South Korea have recently made headlines for experimenting with different methods to incentivise people to have (more) children, in a bid to reverse declining birth rates. Many such incentives—child benefits, cash bonuses, dating events, and so on—appear morally innocuous at first glance. I will demonstrate in this analysis, however, that they amount to stopgap measures which reveal fundamental shortcomings with the way various nation states are approaching the so-called ‘problem’ of fertility decline.

This study assessed the knowledge and perception of human biological materials (HBM) and biorepositories among three study groups in South Korea. The relationship between the knowledge and the perception among different groups was also examined by using factor and regression analyses. In a self‐reporting survey of 440 respondents, the expert group was found more likely to be knowledgeable and positively perceived than the others. Four factors emerged: Sale and Consent, Flexible Use, Self‐Confidence, and Korean Bioethics and Biosafety Action restriction perception. (...) The results indicate that those who are well aware of the existence of biobanks were more positively inclined to receive the Sale and Consent perception. As a result of the need for high quality HBMs and the use of appropriate sampling procedures for every aspect of the collection and use process, the biorepository community should pay attention to ethical, legal, and policy issues. (shrink)

BackgroundThe Life Extension Medical Decision law enacted on February 4, 2018 in South Korea was the first to consider the suspension of futile life-sustaining treatment, and its enactment caused a big controversy in Korean society. However, no study has evaluated whether the actual implementation of life-sustaining treatment has decreased after the enforcement of this law. This study aimed to compare the provision of patient consent before and after the enforcement of this law among cancer patients who visited a tertiary university (...) hospital's emergency room to understand the effects of this law on the clinical care of cancer patients.MethodsThis retrospective single cohort study included advanced cancer patients aged over 19 years who visited the emergency room of a tertiary university hospital. The two study periods were as follows: from February 2017 to January 2018 (before) and from May 2018 to April 2019 (after). The primary outcome was the length of hospital stay. The consent rates to perform cardiopulmonary resuscitation (CPR), intubation, continuous renal replacement therapy (CRRT), and intensive care unit (ICU) admission were the secondary outcomes.ResultsThe length of hospital stay decreased after the law was enforced from 4 to 2 days (p = 0.001). The rates of direct transfers to secondary hospitals and nursing hospitals increased from 8.2 to 21.2% (p = 0.001) and from 1.0 to 9.7%, respectively (p < 0.001). The consent rate for admission to the ICU decreased from 6.7 to 2.3% (p = 0.032). For CPR and CRRT, the consent rates decreased from 1.0 to 0.0% and from 13.9 to 8.8%, respectively, but the differences were not significant (p = 0.226 and p = 0.109, respectively).ConclusionAfter the enforcement of the Life Extension Medical Decision law, the length of stay in the tertiary university hospital decreased in patients who established their life-sustaining treatment plans in the emergency room. Moreover, the rate of consent for ICU admission decreased. (shrink)

General intelligence is largely based on two distinguishable mental abilities: crystallized intelligence (gC) and fluid reasoning ability (gF). The target article authors' P-FIT model emphasizes a network of regions throughout the brain as the neural basis for fluid reasoning and/or working memory. However, it provides little significant insight into the neural basis of gC, or how or why gC is more stable than gF across the life span.

The growing demand for uterus transplantation (UTx) invites continued philosophical evaluation of the function of UTx (and what constitutes its ‘success’), as well as the recipient eligibility for UTx. Currently, UTx caters to partnered, cisgender women of childbearing age looking to get pregnant and give birth to a biogenetically related child. The medical justification for this—the treatment of uterine infertility—explains the primacy of this practice. However, this dominant conceptualization of UTx does not necessarily capture the diverse needs for which both (...) cis‐ and transgender women might take interest in UTx that are not strictly procreative, such as bodily integrity and gender identity reasons. In this paper, I argue that non‐procreative motivations for uterus acquisition ought to be taken seriously as a matter of non‐discrimination and consistency. (shrink)

Mere inability, which refers to what persons are naturally unable to do, is traditionally thought to be distinct from unfreedom, which is a social type of constraint. The advent of biomedical enhancement, however, challenges the idea that there is a clear division between mere inability and unfreedom. This is because bioenhancement makes it possible for some people’s mere inabilities to become matters of unfreedom. In this paper, I discuss several ways that this might occur: first, bioenhancement can exacerbate social pressures (...) to enhance one’s abilities; second, people may face discrimination for not enhancing; third, the new abilities made possible due to bioenhancement may be accompanied by new inabilities for the enhanced and unenhanced; and finally, shifting values around abilities and inabilities due to bioenhancement may reinforce a pre-existing ableism about human abilities. As such, we must give careful consideration to these potential unfreedom-generating outcomes when it comes to our moral evaluations of bioenhancement. (shrink)

A global trend of institutionalised pronatalism situates low fertility as a site of demographic disaster – positioning primarily women’s bodies as both its cause and solution. In light of such demographic dread, assisted reproductive technologies (ART) may be utilized by pronatalist states as a strategy for fertility recovery, rather than as a benefit for individual aspiring parents. In other words, ARTs are at risk of being co-opted by nation-states for problematic demographic designs which do not advance emancipatory goals. The underlying (...) issue of pronatalism, however, is not always explicitly acknowledged in feminist bioethics as a barrier to ethical ART usage. In my paper, I argue that it would be a mistake to assume ART can be used for emancipatory ends if we do not, at the same time, critically investigate its connections to institutionalised pronatalism. (shrink)

Ugar and Malele write that generic machine learning (ML) technologies for mental health diagnosis would be challenging to implement in sub-Saharan Africa due to cultural specificities in how those conditions are diagnosed. For example, they say that in South Africa, the appearance of ‘schizophrenia’ might be understood as a type of spiritual possession, rather than a mental disorder caused by a brain dysfunction. Hence, a generic ML system is likely to ‘misdiagnose’ persons whose symptomatology matches that of schizophrenia in the (...) South African context. The authors thus claim that ‘a generic or universal design cannot be effective given the heterogeneity of value judgements in defining what mental health disorders are in different contexts’.1 Should we take this to mean that ML systems ‘should not be designed with a generalised perception of mental disorders,’1 as the authors suggest? On the contrary, my view is that generic ML can be useful, with the caveat that issues of cultural sensitivity may engender translational challenges in various national and cultural contexts. Yet, if it can be demonstrated that a generic ML system can reliably and accurately pick up on shared symptomatologies across cultures despite what any individual or community might believe about their actual causes, this aspect is surely the function and value of diagnostic ML which we should take to matter. Cultural gaps in aetiological understandings of mental health conditions make it all the more important to advance generic ML as a calibrating diagnostic tool. In this commentary, therefore, I will endeavour to make a case for generic ML in mental healthcare. ### Aetiological (mis)understanding across cultures The fundamental complexity to which Ugar and Malele direct our attention is the fact that mental health conditions are attributed to variable causal explanations, rather than a …. (shrink)

Epistemic injustices are wrongs that agents can suffer in their capacity as knowers. In this article, I offer a conceptualisation of a phenomenon I call anticipatory epistemic injustice, which I claim is a distinct and particularly pernicious type of epistemic injustice worthy of independent analysis. I take anticipatory epistemic injustice to consist in the wrongs that agents can suffer as a result of anticipated challenges in their process of taking up testimony-sharing opportunities. I distinguish my account from paradigmatic cases of (...) epistemic injustice, such as Miranda Fricker’s concepts of testimonial injustice and hermeneutical injustice; additionally, I differentiate my view from Kristie Dotson’s account of testimonial smothering. I argue, ultimately, that anticipatory epistemic injustice is a useful addition to our current taxonomy of epistemic injustices, as it has promising explanatory potential for a range of non-standard cases of epistemic injustice. (shrink)

This research examines how one’s construal level of a crisis differs by crisis type, and how the interplay of crisis type and apology appeal type impacts the effectiveness of apology messages in a corporate crisis context. Findings indicate that one’s mental construal toward a crisis varies by crisis type, with a self-threatening crisis leading to a lower level of construal than a society-threatening one. Findings further suggest that in a society-threatening crisis condition, an informational apology was more effective than an (...) emotional one. However, in a self-threatening crisis condition, there was no significant difference between two different message types. These findings offer valuable guidelines for developing effective crisis response strategy. (shrink)

An episiotomy is ‘an intrapartum procedure that involves an incision to enlarge the vaginal orifice,’1 and is primarily justified as a way to prevent higher degrees of perineal trauma or to facilitate a faster birth in cases of suspected fetal distress. Yet the effectiveness of episiotomies is controversial, and many professional bodies recommend against the routine use of episiotomies. In any case, unconsented episiotomies are alarmingly common, and some care providers in obstetric settings often fail to see consent as necessary (...) in context. In their article, ‘The ethics of consent during labour and birth: episiotomies,’ van der Pijl et al reiterate that consent is necessary for episiotomies. They specify, further, that the antenatal period is crucial for exchanging information, establishing trust between the birthing subject and provider, and exploring the birthing subject’s—rather than the care provider’s—values and preferences regarding episiotomies. They recommend an individualised approach, which would enable birthing subjects to choose how and when they want to give consent. I applaud van der Pijl et al on their practicable recommendations regarding consent for episiotomies. This is certainly a step in the right direction where respect for birthing subjects’ bodily autonomy and integrity is concerned. Still, we must be reminded that consent alone is not coextensive with autonomy. The conditions for securing informed consent in healthcare does not guarantee that one’s decision is truly reflective of their values. After all, even valid consent does not rule out ‘normatively significant external influence’.2 Consent acquisition for obstetric procedures present no …. (shrink)

In this article, I argue that various epistemic challenges associated with eating disorders (EDs) can negatively affect the care of already marginalized patient groups with various EDs. I will first outline deficiencies in our understanding of EDs—in research, healthcare settings, and beyond. I will then illustrate with examples cases where discriminatory misconceptions about what EDs are, the presentation and treatment of EDs, and who gets EDs, instantiate obstacles for the treatment of various ED patient groups.

Customer injustice has received considerable attention in the field of organizational behavior because it generates a variety of negative outcomes. Among possible negative consequences, customer-directed sabotage is the most common reaction, which impacts individuals’ well-being and the prosperity of organizations. To minimize such negative consequences, researchers have sought to identify boundary conditions that could potentially attenuate the occurrence of customer-directed sabotage. In this study, we explore potential attenuation effects of emotional stability and attentiveness on the customer injustice–sabotage linkage. The results (...) showed emotional stability and attentiveness moderate the relationship between customer injustice and customer-directed sabotage. Specifically, the representatives with higher emotional stability or higher attentiveness are less likely to engage in customer-directed sabotage when they experience customer injustice. Moreover, there is a three-way interaction among daily customer injustice, emotional stability, and attentiveness that predicts daily customer-directed sabotage. Theoretical and practical contributions, limitations, and directions for future development are also discussed. (shrink)

Individualistic traditions of autonomy have long been critiqued by feminists for their atomistic and asocial presentation of human agents. Relational approaches to autonomy were developed as an alternative to these views. Relational accounts generally capture a more socially informed picture of human agents, and aim to differentiate between social phenomena that are conducive to our agency versus those that pose a hindrance to our agency. In this article, I explore the various relational conceptualizations of autonomy profferred to date. I critically (...) review some of the ongoing internal disputes within the relational autonomy literature, and conclude the article by taking stock of the value of relational autonomy despite these unresolved debates. (shrink)

Uterus transplantation (UTx) is an experimental surgery likely to face the issue of organ shortage. In my article, I explore how this issue might be addressed by changing the prevailing practices around live uterus donor recruitment. Currently, women with children – often the mothers of recipients – tend to be overrepresented as donors. Yet, other potentially eligible groups who may have an interest in providing their uterus – such as transgender men, or cisgender women who do not wish to gestate (...) or to have children – tend to be excluded as potential donors. Moving forward, I recommend that donor inclusion criteria for UTx be broadened to be more inclusive of these latter groups. (shrink)