Biocontainment units (BCU) are purpose-built to provide medical care for patients with high consequence infectious diseases (e.g., viral haemorrhagic fevers, Middle East respiratory syndrome) and to contain the risk of d...Biocontainment units (BCU) are purpose-built to provide medical care for patients with high consequence infectious diseases (e.g., viral haemorrhagic fevers, Middle East respiratory syndrome) and to contain the risk of disease spread. In the United States, high consequence infectious diseases (HCID) are often quarantinable diseases designated by the Centers for Disease Control and Prevention and state and local health departments, and BCU play a prominent role when public health faces an HCID threat. Patients admitted to a BCU have access to a high resource healthcare setting, but admission to the unit comes with restrictions to the rights and liberties of patients. This article begins with an introduction to BCUs and the preparedness activities that ensure the units are ready to respond. Next, it explores the significance of public health ethics for two public health interventions-quarantine and isolation care and diagnostic testing-that may place burdens on patients in a BCU. Finally, we make recommendations for integrating ethical considerations into preparedness activities to develop, formulate, and justify plans and protocols before the need to implement them in a BCU arises.
Introduction While there is a global consensus that Lay Community Health Workers (CHWs) should be formally remunerated for their time and effort, they remain unsalaried in most Sub-Saharan African countries, including Za...Introduction While there is a global consensus that Lay Community Health Workers (CHWs) should be formally remunerated for their time and effort, they remain unsalaried in most Sub-Saharan African countries, including Zambia. Does this constitute exploitation? To answer this question, we conducted a qualitative study in Lusaka province of Zambia where we interviewed Lay CHWs attached to government healthcare facilities. We juxtaposed the Sub-Saharan African Communitarian (Ubuntu) ethical system and Western ethics to discuss the findings. Study Methods We conducted qualitative interviews with thirty-five Lay Community Health Workers in three districts of Lusaka province in Zambia. We adapted the Braun and Clarke (2006) six-step framework of thematic analysis and NVivo computer software to analyse data. Study Findings Lay CHWs were motivated by both the intrinsic Ubuntu altruism and economic benefits as they provided community health services in their respective localities. Although they complained about low and inconsistent stipends, as well as a lack of equipment, that did not stop them from serving their communities because of their intrinsic Ubuntu motivation to care for others. Conclusion Our study found no evidence that paying Lay CHWs undermined their intrinsic Ubuntu motivation to aid other people, as they continued to serve their communities whether they received stipends or not. It is also our considered view that Lay CHWs are exploited due to their vulnerable positionality, and to avoid that, they should be formally remunerated in line with the WHO recommendation.
This paper argues that viewing informed consent as an autonomous action is problematic because it is based on an idealized conception of the person and of autonomy. Instead, informed consent should be viewed as the objec...This paper argues that viewing informed consent as an autonomous action is problematic because it is based on an idealized conception of the person and of autonomy. Instead, informed consent should be viewed as the objective activity of real, concrete persons. In this activity, an individual, acting as a subject, authorizes a specific object for a particular purpose. A person's choice is fundamentally constrained by the reality of both the object and the subject (the individual themselves). Accordingly, individuals must understand the nature of the object and its relevance to their own situation in order to make appropriate decisions. However, since cognitive activity is fundamentally constrained by practical conditions, there is no assurance that individuals can achieve sufficient understanding when making a consent decision. Therefore, the cognitive goal of informed consent should not be to ensure complete understanding in advance but to maximize the likelihood that sufficient understanding will be achieved. The appropriate cognitive threshold must also vary according to the actual circumstances of each individual. On this basis, the paper proposes a more complete informed consent process consisting of three stages: pre-consent communication, post-consent verification, and consent process optimization.
While existing literature often portrays China's human genetic resource (HGR) regulations as primarily restrictive, this report demonstrates their evolution towards a more sophisticated and balanced framework. First, Chi...While existing literature often portrays China's human genetic resource (HGR) regulations as primarily restrictive, this report demonstrates their evolution towards a more sophisticated and balanced framework. First, China's transition from addressing biopiracy to incorporating HGR management into national security frameworks reflects a reconceptualization of genetic resources as strategic assets. Second, regulatory changes since 2023 show increasing flexibility in international collaboration, particularly in clinical trials, whilst maintaining protective measures. Third, regarding ethical management, the absence of clear legal distinctions between HGRs at the natural state and processed cellular products may negatively affect biotech industry development, while donors' property rights over their genetic resources remain unsettled. These findings demonstrate how China has continuously refined its HGR regulatory framework to protect national interests whilst advancing innovation and international scientific cooperation.
Identifying the trends and patterns of bioethics research in the Eastern Mediterranean Region provides valuable insights into research interests and productivity. This study aimed to evaluate the region's bioethics resea...Identifying the trends and patterns of bioethics research in the Eastern Mediterranean Region provides valuable insights into research interests and productivity. This study aimed to evaluate the region's bioethics research outputs between 1974-2022 using a bibliometric approach. Publications from countries in the region indexed in Web of Science, Scopus, and PubMed were analysed. The results showed a clear upward trend, with an average annual growth rate of 39 per cent in bioethics publications, while the growth rate of citations was nearly twice as high. Iran was identified as the most prolific country, followed by Saudi Arabia and Pakistan. However, intra-regional and extra-regional co-authorships accounted for only 7 per cent and 17 per cent of publications, respectively, indicating limited research collaboration. The main non-regional collaborators were the United States, Canada, and the United Kingdom. Further development of bioethics research in the region requires strengthened capacity building at both national and regional levels.
In the digital age, where physical space constraints in scholarly publishing have largely diminished, the recurring editorial justification of "limited space" for manuscript rejection appears increasingly indefensible. T...In the digital age, where physical space constraints in scholarly publishing have largely diminished, the recurring editorial justification of "limited space" for manuscript rejection appears increasingly indefensible. This commentary critically examines the ethical and economic dimensions of this rationale, particularly when it results in redirection to fee-based open access (OA) sister journals. While peer-reviewed publication decisions are ideally grounded in scientific merit, novelty, and methodological rigor, the authors argue that the space limitation rationale may function as a pretext to curate journal branding or steer submissions toward revenue-generating platforms. The expansion of OA publishing, though intended to democratize knowledge dissemination, has in some cases evolved into a profit-driven model that imposes article processing charges on authors. Such practices risk compromising editorial transparency, fairness, and academic equity. The authors advocate for clearer editorial policies, increased transparency in decision-making, and the adoption of mechanisms such as dynamic submission dashboards to inform authors of real-time publication capacity. Rejections should be based on scholarly merit rather than logistical or commercial interests. This article calls for reinforcing the ethical foundations of academic publishing to ensure that decisions reflect genuine scholarly standards and not economic expediency.
The COVID-19 pandemic has exacerbated health resource scarcity in many countries. Due to the shortage of medical equipment, some health workers in Zimbabwe refused to provide health services until these needs were addres...The COVID-19 pandemic has exacerbated health resource scarcity in many countries. Due to the shortage of medical equipment, some health workers in Zimbabwe refused to provide health services until these needs were addressed. In this article, we analyse the case of withdrawal of services by health workers in Zimbabwe and contend that they were morally justified in doing this. To forward this thesis, we try for the first time to use the African values of partiality and social harmony to evaluate the morality of health workers striking during a pandemic. The first set of arguments, based on the African ethics of partiality, is divided into two sub-arguments: namely, that the health workers were justified in withdrawing medical services because they held special duties to their families which could be violated if they had provided health services without the use of protection, and that it is psychologically unrealistic to demand that health workers put their families at risk. The second set of arguments upholds that the actions of the health workers are grounded in the idea of Ubuntu/social harmony and, therefore, are morally justified. Finally, we contend that although our thesis implies some hierarchies, not only may these be morally justified, but they are also not necessarily incompatible with the ethical standards of equality, universality, and non-favouritism. Although the case of Zimbabwe serves as an illuminating example, the way we formulate this thesis indicates that the arguments can be generalized to similar settings.
The bioarchaeological study of identified human remains represents a powerful tool for reconstructing past lives and enriching historical knowledge. Through osteobiography, it is possible to integrate bioanthropological,...The bioarchaeological study of identified human remains represents a powerful tool for reconstructing past lives and enriching historical knowledge. Through osteobiography, it is possible to integrate bioanthropological, archaeological, molecular, and archival data to provide a deeper understanding of individual life histories. However, this approach raises ethical concerns, particularly regarding post-mortem privacy, the right to be forgotten, and the limits of public disclosure. While scientific research contributes to preserving individual and collective memory, it must also consider the perspectives of descendant communities and the potential social and cultural implications of disseminating such detailed personal information. This paper explores these ethical dilemmas, reporting different case studies and discussing the challenges of balancing scientific inquiry, historical memory preservation, and respect for the deceased's dignity. The article aims to encourage further critical reflection on the management of post-mortem memory in anthropological research.
Individualized therapies for ultra-rare diseases blur the lines between clinical care and medical research, creating emotional and practical entanglements. These entanglements, in the absence of clear ethical guidelines,...Individualized therapies for ultra-rare diseases blur the lines between clinical care and medical research, creating emotional and practical entanglements. These entanglements, in the absence of clear ethical guidelines, put pressure on the fundamental right to withdraw. Conventional ethical guidelines treat withdrawal as absolute, unconditional, complete, and immediate; yet, in personalized therapies, abrupt withdrawal can mean significant scientific and societal losses. We argue for a shift: a dynamic approach to the right to withdraw, treating it not as a one-time decision but as an evolving dialogue throughout therapy development. Through reconstructing the patient journey, we highlight how bodily involvement, uncertainty, mutual dependence, and resource intensity vary across development phases. As these aspects evolve, the right to withdraw assumes different meanings. Shaping the right to withdraw as a dynamic allows for the exploration of patient perspectives and motivations and for balancing patient autonomy with the social and scientific value of individualized therapies. Such an approach turns the concept of the right to withdraw into an avenue for patient engagement and addressing early concerns, preventing any unnecessary adverse effects of withdrawal.
This article examines the role of patient organizations as mediators between patients and researchers in stem cell research in Australia. We conducted semi-structured interviews with stem cell researchers and patient org...This article examines the role of patient organizations as mediators between patients and researchers in stem cell research in Australia. We conducted semi-structured interviews with stem cell researchers and patient organization representatives as part of a broader project to deepen public understanding and foster more robust scientific practices in stem cell-based research and therapies. We used Habermas's Theory of Communicative Action as our theoretical framework to explore the relationships between patient organizations and researchers. Using this framework allowed the identification of two different ways of conceptualizing health and illness-one based on patients' experiences, which we call "the lifeworld," and another grounded on researchers', health professionals', and policymakers' professional perspectives, which we call "the rational system." We found that the different conceptualizations identified influenced the interactions between patients and researchers (and other professionals involved in the healthcare system). Patient organizations, then, act as articulators of patients' viewpoints in this scenario, which can have advantages and disadvantages. We also found that researchers need to develop less transactional forms of communication with these organizations and that policymakers and regulators could benefit from developing guidelines to encourage researchers to use diverse strategies to engage more meaningfully with patients at individual and organizational levels.
The rapid advancement of human germline gene editing (HGGE) technology has brought opportunities for gene therapy in patients with rare diseases. However, due to risks related to technical safety, ethics, and societal co...The rapid advancement of human germline gene editing (HGGE) technology has brought opportunities for gene therapy in patients with rare diseases. However, due to risks related to technical safety, ethics, and societal concerns, some countries have explicitly prohibited the application of germline gene editing. In reality, the use of HGGE for correcting genetic diseases contributes to safeguarding the fundamental rights of patients with rare genetic disorders and their offspring. The off-target effects of CRISPR/Cas9 gene editing technology are controllable, and preliminary clinical successes have been achieved, with a low probability of substantial harm. Moreover, the expected number of actual applications is minimal, meaning it will not significantly alter the human gene pool in the short term. When applied reasonably, HGGE for correcting genetic diseases does not pose the aforementioned ethical or social risks. Its application is ethically justified, and by implementing matching safety safeguards and regulatory frameworks, the legalization of HGGE for genetic disease correction can be achieved, thereby balancing technological innovation with human rights protection.
Future artificial reproductive technologies, including mitochondrial replacement therapy, in vitro gametogenesis, and ectogenesis raise important legal and ethical questions, such as: Who should be considered the parents...Future artificial reproductive technologies, including mitochondrial replacement therapy, in vitro gametogenesis, and ectogenesis raise important legal and ethical questions, such as: Who should be considered the parents of children born from these technologies? The concept of biological parenthood is commonly used as a basis for answering this question. Therefore, this study assesses the use and meaning of biological parenthood in relation to these future artificial reproductive technologies. Searches were conducted in six databases, including PubMed, PsycINFO, Web of Science, HeinOnline, Westlaw Classic, and Philosopher's Index. Articles were included only if they met one of the following conditions: 1) a definition of biological parenthood, 2) a definition of genetic parenthood, 3) a definition of gestational parenthood, 4) a definition of biological, genetic, or gestational parenthood combined with either mitochondrial replacement therapy, in vitro gametogenesis, or ectogenesis. Of the 6,304 studies retrieved, 131 results were included for analysis. The review found multiple meanings of biological parenthood, encompassing different biological ties (genetic, gestational, and postnatal) and diverse conceptual methods of interpreting its meaning. The definition of gestational parenthood appears to be less univocal than the term initially suggests, and that of genetic parenthood has evolved. The lack of consensus on the meaning and definition of biological parenthood leads to inconsistent determinations of biological parenthood in relation to future artificial reproductive technologies. This raises serious doubts about whether biological parenthood can continue to play the fundamental role in ethical and legal perspectives on parenthood that it has held for a long time.
Amid the intensifying global ecological crisis and the enduring dominance of anthropocentric ideologies, this study re-examines Shunji Iwai's Wallace and a Mermaid through the lenses of ecological ethics, posthuman philo...Amid the intensifying global ecological crisis and the enduring dominance of anthropocentric ideologies, this study re-examines Shunji Iwai's Wallace and a Mermaid through the lenses of ecological ethics, posthuman philosophy, and East Asian oceanic culture. Drawing upon Deleuze's concept of becoming, feminist ecocriticism, and non-anthropocentric thought, this research analyses the mermaid as a hybrid and liminal figure that destabilizes species hierarchies and gender binaries. Simultaneously, the ocean is interpreted as a decentralized and generative space, central to reconfiguring ecological subjectivity and ethics. Integrating East Asian marine imaginaries of maternal generativity and boundary dissolution, the study elucidates how the narrative critiques anthropocentrism and reimagines interspecies coexistence within a global ecological framework. Ultimately, this paper advances a posthuman ethical paradigm grounded in fluid identity, relationality, and planetary interdependence, contributing to contemporary ecological philosophy and oceanic literary studies.
The dominant method of assessment for decisional capacity, the "four abilities" model, relies heavily on the reasoning abilities of the patient. This paper argues that the rational thinking required of medical patients t...The dominant method of assessment for decisional capacity, the "four abilities" model, relies heavily on the reasoning abilities of the patient. This paper argues that the rational thinking required of medical patients to preserve their autonomy is a legal anomaly that is highly inconsistent with other areas of law, including the rules related to high-stakes social and economic decisions. The model also denies autonomy to a subset of individuals who possess strongly held and longstanding preferences regarding their care but are unable to explain the bases for these preferences in a manner satisfactory to physicians. Following up on recent challenges to the "four abilities" model by Fogal and Schwan, among others, this paper argues for an alternative model that embraces a values-based approach when such values are known and a "consistent preferences" approach when they are not known.
Throughout African American medical history, Black epileptic women have been rendered unwillingly invisible, both as enslaved persons and as patients, and were often construed as defective, resistant, malingering, or dis...Throughout African American medical history, Black epileptic women have been rendered unwillingly invisible, both as enslaved persons and as patients, and were often construed as defective, resistant, malingering, or disabled. A challenge therefore arises for bioethics scholarship when modern, white-dominated psychiatric institutions conceal the impairment of Black epileptic women within the malleable demarcation of disability. The article advances two distinct yet interrelated perspectives on the concept of disability. First, it theorizes the significance and appliedness of disability bioethics within the fluid intersection of race, gender, and epilepsy. Adopting a "binocular" approach that integrates the medical and social models of disability, it draws on theoretical insights ranging from Penny Rhodes to Sigrid Graumann to problematize the disability epistemology and cultural competence of white physicians in their treatment of impaired and disabled Black epileptic women. Second, the article examines how white physicians proselytize impairment into disability, thereby calling into question notions of "Black dignity." Through a close reading of Rebecca Skloot's The Immortal Life of Henrietta Lacks (2010), it investigates the spectral presence and narratively captured deformed face of Elsie Lacks, an impaired epileptic woman subjected to medical experimentation at Crownsville State Hospital. Drawing on the social model of disability articulated by Rosemarie Garland-Thomson, the article foregrounds the interlacing stereotypes, the severity of racism and ableism, and the perils of psychiatric treatment experienced by Black epileptic women.