黑斯廷斯中心报告探讨了医学、医疗保健、公共卫生和生命科学领域的伦理、法律和社会问题。每年六期提供文章、论文、生物伦理问题的案例研究、法律和政策专栏、照顾者的故事、同行评议的学术文章和书评。作者来自各行各业和学科，表达了一系列观点和政治观点。该报告的读者群包括医生、护士、学者、行政人员、社会工作者、健康律师和其他人。

The Hastings Center Report explores ethical, legal, and social issues in the fields of medicine, healthcare, public health, and life sciences. It publishes six issues annually, featuring articles, papers, case studies on bioethics, legal and policy columns, caregiver stories, peer-reviewed scholarly articles, and book reviews. Authors come from various fields and disciplines, presenting a range of perspectives and political viewpoints. The report's readership includes physicians, nurses, scholars, administrators, social workers, health lawyers, and others.

《Hastings Center Report》探讨医学、医疗保健、公共卫生和生命科学领域的伦理、法律和社会问题。该期刊每年出版六期，内容包括文章、论文、生物伦理案例研究、法律与政策专栏、照顾者故事、同行评审的学术文章和书评。作者来自不同领域和学科，表达多样的观点和政治立场。该报告的读者群体包括医生、护士、学者、行政人员、社会工作者、健康律师等。

Hastings Center Report

Abstract Alcohol is a class 1 carcinogen, and its use, at any level, is not safe for health. Despite this, alcohol remains strongly mixed into medical culture and is often served free at medical‐community events. This presents numerous ethical concerns. First, the funding of alcohol‐centered events by the medical community reinforces alcohol consumption as a coping mechanism for stress, perpetuates the perceived need for alcohol for socialization, and falsely implies that it is a safe substance. Additionally, the medical community is increasingly diverse, including Muslims, Mormons, those in recovery from substance use disorders, pregnant individuals, and individuals from homes and communities damaged by alcohol. Due to their moral or safety concerns, these individuals may miss opportunities to network and engage in professional development when alcohol is present. Therefore, alcohol acts as a barrier to diversity, equity, and inclusion efforts and can result in pernicious downstream effects for minority patient populations .

Luqman M. Ellythy

Ian M. Michel

Elizabeth K. Farkouh

Aasim I. Padela

The Hastings Center Report

Alcohol and the Medical Community: A Cocktail for Exclusion

酒精与医学界：一杯排外的鸡尾酒

Abstract This letter responds to the essay “Language Matters: The Semantics and Politics of ‘Assisted Dying,’” by Anna M. Elsner, Charlotte E. Frank, Marc Keller, Jordan O. McCullough, and Vanessa Rampton, in the September‐October 2024 issue of the Hastings Center Report.

Richard W. Sams

Peter Jaggard

Speaking Truthfully about Provider‐Assisted Death

关于医助死亡的诚实探讨

Abstract The laws of medical malpractice have historically differed in significant ways from general liability laws. Until the mid‐twentieth century, physician liability in the United States was limited to cases in which the doctor and patient had an established professional relationship. In the 1970s, courts and legislatures began carving out exceptions when patients posed an imminent threat to identifiable third parties. Recently, a series of cases involving circumstances such as curbside consultation, threats of violence, and automotive accidents have led some state courts to abandon the requirement of a preexisting physician‐patient relationship. Instead, the courts now focus on whether foreseeable reliance is present. While these developments may significantly impact clinical practice, the connections between these cases have gone largely overlooked by both the medical and bioethics communities. This essay aims to highlight these parallel developments and to suggest that this evolution reflects a broader trend with implications far beyond the individual cases themselves .

Jacob M. Appel

The Insidious Foreseeability Revolution

隐秘的可预见性革命

Abstract Many of us in the modern world find ourselves implicated in massive, structural harms and injustices. We emit greenhouse gases, which—along with everyone else's emissions—are warming the planet. We buy products that result from bad labor practices. And many of us feel (appropriately, I think) some amount of guilt for our participation, but also find it difficult or impossible to fully extract ourselves from the problematic systems. I call this challenge of determining individual moral responsibility in the face of massive, structural problems “catastrophe ethics.” In this Perspective commentary, I suggest that the ubiquity of catastrophe ethics cases in the modern world justifies adopting a position of moral humility, as we recognize that none of us is morally pure but, rather, we are each choosing our own version of impurity .

Travis N. Rieder

Moral Humility for a Complex World

复杂世界中的道德谦逊

Abstract What makes certain scientific research controversial? And when does scientific research go beyond being merely controversial to be something far worse? We propose a diagnostic framework for distinguishing between scientific research that is merely controversial and that which is abhorrent. Our framework places research projects along two axes of a value‐harm map. Most research, fortunately, is both valuable and harmless. However, research may be controversial if it is either valuable but harmful or harmless but valueless. The most concerning quadrant of our value‐harm map includes research that is both valueless and harmful, which is abhorrent science. The article's analysis considers a series of case studies, highlighting “new genomic race science” as an exemplar of abhorrent science .

Lucas J. Matthews

James Tabery

Eric Turkheimer

How to Diagnose Abhorrent Science

如何诊断异常科学

Abstract Community engagement and participatory research have been appropriately employed to increase the relevance, rigor, and acceptability of all types of research, but these approaches may be particularly important in genomics and biomedical research on sensitive traits such as neurodevelopmental, psychiatric, and behavioral ones. Here, we provide an overview of past and ongoing efforts in community engagement in genomics studies and consider successes and opportunities for further improvement. Informed by this knowledge as well as one of the author's experiences, we set out a vision for a more equitable and collaborative genomics where wider communities, including social, ethnic, and other communities that share a particular trait, are included in the research as peers and collaborators, not solely as objects of study.

Heini M. Natri

Carolyn Riley Chapman

Toward Justice and Community Empowerment in Genomics Studies on Sensitive Traits

迈向敏感特征基因组学研究中的正义与社区赋权

Abstract The integration of genomics into public health and medicine is happening at a faster rate than the accrual of the capabilities necessary to ensure the equitable, global distribution of its clinical benefits. Uneven access to genetic testing and follow‐up care, unequal distribution of the resources required to access and participate in research, and underrepresentation of some descent groups in genetic and clinical datasets (and thus uncertain genetic results for some patients) are just some of the reasons to center justice in genomics. A more just genomics is an imperative rooted in the ethical obligations incurred by a publicly funded science that is reliant on human data. These features of genomics indebt the genomics enterprise and compel the expanded scope of responsibility proposed by the authors of this special report. The report begins to define justice in genomics for different stakeholder groups and proposes substantial shifts in power, resource distribution, scientific practice, and governance that could enable genomics to meet its obligations to humanity.

Deanne Dunbar Dolan

Danielle M. Pacia

Josephine Johnston

Sandra Soo‐Jin Lee

Mildred K. Cho

Expanding the Agenda for a More Just Genomics

拓展议程以实现更公正的基因组学

Abstract This paper describes the unique values of, challenges within, and opportunities presented by embedded ELSI ethnography. Drawing from our six‐year embedded ELSI study of the WISDOM (Women Informed to Screen Depending on Measures of Risk) trial, we present three examples of the variable ways we engaged with the WISDOM trial's scientific team. WISDOM is a preference‐sensitive, pragmatic, randomized controlled trial of risk‐based breast cancer screening informed by genomics. Our embedded ELSI approach included multiple modes of engagement: (a) Trial investigators sought bioethics expertise; for example, we were asked to consult on traditional bioethics topics such as consent as well as more complex questions about whether to implement a specific risk‐assessment approach on only one race‐defined group of trial participants. (b) As the ELSI investigators, we identified ethical concerns in issues that surfaced via ethnography and considered them in the Bioethics Working Group; for example, there were concerns about the implementation processes that the WISDOM team viewed as logistical challenges. (c) Our presence in WISDOM working group conversations and our expertise on classic social science topics, including race and gender, offered opportunities to engage on the spot with topics such as how to include transgender participants in a trial initially focused on “women's health”; through such engagement, the value of social science became clear to the trial investigators. The paper elaborates on the dynamic relationship between our ethnographic observations, the Bioethics Working Group discussions, and the contributions of each to our real‐time ELSI interventions in these examples. The methods and experiences we describe here suggest modes of engagement that, in combination, have the potential to expand the role of ELSI to offer real‐time intervention on issues related to equity, inclusion, and justice in genetic and genomic research.

Jennifer Elyse James

Leslie Riddle

Barbara Koenig

Galen Joseph

Moving toward Equity through Embedded ELSI Ethnography

通过嵌入式ELSI民族志迈向公平

Abstract The rapid advances in genomics over the last decade have come to fruition amid intense public discussions of justice in medicine and health care. While much emphasis has been placed on increasing diversity in genomics research participation, an overly narrow focus on recruitment eschews recognition of the disparities in health care that will ultimately shape access to the benefits of genomic medicine. In this essay, we suggest that achieving a just genomics, both now and in the future, requires an explicit ELSI of translation—normative and pragmatic scholarship that embraces the interconnectedness of research and clinical care and centers the obligations of researchers, institutions, and funders to mitigate inequities throughout the translational pipeline. We propose core principles to guide an ELSI of translation and to ensure that this work balances the value of the generalizable knowledge that genomics research generates and the value of the individuals and communities who make this research possible.

Meghan C. Halley

Nate W. Olson

Euan A. Ashley

Aaron J. Goldenberg

Holly K. Tabor

A Just Genomics Needs an ELSI of Translation

公正的基因组学需要翻译的伦理、法律和社会影响（ELSI）

Abstract Effectively addressing ethical issues in precision medicine research in Africa requires a holistic social contract that integrates biomedical knowledge with local cultural values and Indigenous knowledge systems. Drawing on African epistemologies such as ubuntu and ujamaa and on our collective experiences in genomics and big data research for sickle cell disease, hearing impairment, and fragile X syndrome and the project Public Understanding of Big Data in Genomics Medicine in Africa, we envision a transformative shift in health research data governance in Africa that could help create a sense of shared responsibility between all stakeholders in genomics and data‐driven health research in Africa. This shift includes proposing a social contract for genomics and data science in health research that is grounded in African communitarianism such as solidarity, shared decision‐making, and reciprocity. We make several recommendations for a social contract for genomics and data science in health, including the coproduction of genomics knowledge with study communities, power sharing between stakeholders, public education on the ethical and social implications of genetics and data science, benefit sharing, giving voice to data subjects through dynamic consent, and democratizing data access to allow wide access by all research stakeholders. Achieving this would require adopting participatory approaches to genomics and data governance.

Nchangwi Syntia Munung

Charmaine D. Royal

Carmen de Kock

Gordon Awandare

Victoria Nembaware

Seraphin Nguefack

Marsha Treadwell

Ambroise Wonkam

Genomics and Health Data Governance in Africa: Democratize the Use of Big Data and Popularize Public Engagement

非洲基因组学与健康数据治理：推动大数据应用的民主化与公众参与的普及

Abbreviation	Hastings. Cent. Rep.
Journal Impact	2.20
Quartiles(Global)	SOCIAL SCIENCES, BIOMEDICAL(Q2)

ISSN	0093-0334, 1552-146X
h-index	72

Publication Information	Publisher: Wiley-Blackwell，Publishing cycle: Bimonthly，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 1971，Proportion of original research papers: 100.00%，Self Citation Rate:8.70%， Gold OA Rate: 11.25%
Average review cycle	网友分享经验：较慢,6-12周
Average recruitment ratio	网友分享经验：容易

Hastings Center Report

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