As the world grapples with escalating global health and environmental crises, existing Western bioethics frameworks tend to fall short in addressing the complex interdependencies between human, animal, and ecological hea...As the world grapples with escalating global health and environmental crises, existing Western bioethics frameworks tend to fall short in addressing the complex interdependencies between human, animal, and ecological health, as well as the diverse cultural and belief systems in many parts of the world. Eco-bio-communitarianism, a bioethics framework informed by an African indigenous worldview, provides a commonsensical, practical, and comprehensive approach that can bring about positive change in global and public health. The framework promotes the principles of planetary kinship, relational interdependence, non-anthropocentricity, eco-bio-centricity, and cosmic humility. Unlike mainstream bioethics, which is frequently driven by individual autonomy and biomedical reductionism, eco-bio-communitarianism situates health within a broader moral ecology that recognizes the interconnectedness of all life forms, including humans, non-human species, ecosystems, and cultures. This paper showcases the practical application and utility of eco-bio-communitarianism through a series of case studies addressing and examining zoonotic disease management, biotechnology governance, and gene therapy. Far from dismissing Western bioethics models, eco-bio-communitarianism invites a pluralistic and decolonial expansion of global bioethics, one that respects cultural specificities and advances ecological responsibility and relational justice, while urging public health practitioners, policymakers, and global health actors to embrace a more inclusive, relational, and culturally attuned perspective to global health and the biomedical sciences.
Human immunodeficiency virus (HIV) phylogenetic analysis has been introduced in a select number of jurisdictions globally for the purposes of HIV public health surveillance. Using this epidemiological tool in this way ca...Human immunodeficiency virus (HIV) phylogenetic analysis has been introduced in a select number of jurisdictions globally for the purposes of HIV public health surveillance. Using this epidemiological tool in this way can enhance public health efforts aimed at managing HIV transmission. This application, however, presents many legal and ethical concerns that may counter such efforts, particularly in regulatory environments where HIV transmission can be subject to criminal prosecution. This article uses Victoria, Australia, as a case study and analyses the current regulatory frameworks relevant to HIV transmission and explores how these may influence the future implementation of phylogenetic analysis in this setting. The article concludes by offering a series of regulatory recommendations including considerations relevant to law and policy reform; procedures and practice; education and guidance; and community engagement and research.
This paper discusses the idea of moral deference in the context of the ongoing war in Gaza. This idea is particularly pertinent where many ethicists seem to share the sense that the Israeli onslaught in Gaza is immoral,...This paper discusses the idea of moral deference in the context of the ongoing war in Gaza. This idea is particularly pertinent where many ethicists seem to share the sense that the Israeli onslaught in Gaza is immoral, and yet only few articulate it in writing. Moral deference, I suggest, can be a temporary measure against such paralysis, by referring to international humanitarian law.
As artificial intelligence (AI) becomes increasingly integrated into healthcare decision-making, concerns arise regarding deference to AI systems. While existing discussions highlight issues such as the opacity of AI out...As artificial intelligence (AI) becomes increasingly integrated into healthcare decision-making, concerns arise regarding deference to AI systems. While existing discussions highlight issues such as the opacity of AI outputs and responsibility gaps, this paper introduces a new concern: the impact of deference to AI on decision ownership among healthcare professionals. I argue that reliance on AI can lead to a diminished sense of ownership over decisions based on AI-generated outputs. This consequence is problematic, as a strong sense of decision ownership is essential for ensuring high quality patient care. I recommend that this concern be taken into consideration when implementing the use of AI in healthcare contexts. To address the concern, training and policies should discourage healthcare professionals from simply deferring to AI. Instead, we should encourage such professionals to treat AI as merely an assistive tool, which complements rather than replaces their expertise. Whenever there is any doubt or lack of understanding associated with an AI output, further measures must be taken before a decision is made.
In the realm of dental treatment for individuals with disabilities, ethics plays a fundamental role by emphasizing the foundational principles of respect, dignity, and equitable access to dental care. Living with disabil...In the realm of dental treatment for individuals with disabilities, ethics plays a fundamental role by emphasizing the foundational principles of respect, dignity, and equitable access to dental care. Living with disabilities exerts a considerable impact upon the daily lives of affected individuals-one recognized by Ecuadorian disability law-which highlights the imperative role of caregivers in providing necessary support. Therefore, the objective of this study was to identify the perception of ethics in dental treatments of people with disabilities. The conducted study, involving the participation of thirty-five dentists in Ecuador, seeks to discern ethical perceptions surrounding dental treatments. It underscores the pressing need to synchronize ethical-moral values with tailored procedures to achieve truly inclusive care. A comprehensive approach to ethics in dentistry for individuals with disabilities is imperative. This entails a thorough consideration of individual needs and the application of ethical-moral values. Continuous education and interdisciplinary collaboration stand out as indispensable components to provide quality and respectful care. The study serves to underscore the paramount importance of ethics in the dental field, emphasizing the need to adapt to diversities and ensure inclusion in the provision of care to patients with disabilities.
This paper maps the ethical concerns involved in using new technologies in the care of older persons by type of participant group and technology used. The study presents data from sixty-seven participants in total from t...This paper maps the ethical concerns involved in using new technologies in the care of older persons by type of participant group and technology used. The study presents data from sixty-seven participants in total from three stakeholder groups (older persons, professional caregivers, and family caregivers) who relayed their opinions on three types of technologies: wearables, ambient sensors, and social assistive robots. The interview data collected was analysed using content analysis. Participants raised ethical concerns about user control, stigma, over-reliance on technology, isolation, deception, privacy breaches, and the replacement of human care. However, these concerns were not uniformly emphasized across participant groups, and not all concerns applied to each of the three technologies. Our findings revealed a reduced ethical sensitivity and preparedness for risk in the case of certain technologies. These ethical blind spots evident in our results pertained to privacy, stigma, and deception. With technologies continuously developing, such blind spots are a cause for concern.
Across the United States, every state establishes their own requirements for the disposition of foetal remains, including laws that address the disposal and reporting of foetal remains after a foetal death has occurred....Across the United States, every state establishes their own requirements for the disposition of foetal remains, including laws that address the disposal and reporting of foetal remains after a foetal death has occurred. Most states discard foetal remains as biohazard material, processed by healthcare facilities through medical incineration or sterilization. However, there are variations among state laws, with some states imposing specific requirements for the disposal of foetal remains and treating foetuses as persons. To examine these differences, I reviewed U.S. state statutes on foetal disposition, focusing on states with restrictive requirements for miscarried or aborted remains under twenty weeks gestation. In this paper, I analyse the thirteen states identified as having restrictive foetal disposition requirements. I describe the implications of restrictive foetal disposition laws and argue that these requirements allow states to govern foetal death in ways that infringe upon abortion and miscarriage patients' autonomy. Following the decision in Dobbs v. Jackson Women's Health Organization [2022] Supreme Court of the United States. No. 19-1392, I argue that foetal disposition laws could be weaponized to further strategize the political value assigned to foetuses and buttress abortion and miscarriage reporting, thus criminally implicating patients who have lost or terminated pregnancies. With reproductive autonomy rapidly declining in the United States, validating variable responses to foetal death and recognizing the relational nature of pregnancy loss and termination could better uphold patient autonomy and privacy.
This paper considers if certain sexual activities or practices can legitimately be thought of as raising concerns about an individual's professionalism and, therefore, as matters which fall within the purview of bodies w...This paper considers if certain sexual activities or practices can legitimately be thought of as raising concerns about an individual's professionalism and, therefore, as matters which fall within the purview of bodies which regulate healthcare professionals. There seems prima facie reason to think that healthcare professionals should be able to enjoy the same socio-political rights as anyone else. Given that this includes the right to privacy, then the suggestion that a professional regulator might legitimately concern themselves with the sex lives of those they regulate seems problematic on its face. However, some of the activities discussed are not entirely private matters. Equally, whilst the practices addressed are not unlawful, it is not unusual for them to be the subject of judgmental attitudes, prejudice, and stigma. Coupled with the fact that regulatory bodies are commonly charged with maintaining public trust and confidence it may be that there is some reason to consider the kinds of activities discussed with regard to the professionalism of those who engage in them. Nevertheless, one might question the legitimacy of impugning an individual's professionalism on the basis of intolerance, and whilst I note that there may be a need for empirical research into public opinion, this essay concludes that the distinction between the personal and professional should be maintained. Assuming that it is conducted within the bounds of the law, the sex lives of healthcare professionals should not draw the attention of professional regulators.
INTRODUCTION: Midwives are frequently confronted with ethical dilemmas and require guidance in addressing them. This study investigates Lebanese midwives' recognition of and perception of ethical dilemmas in clinical pra...INTRODUCTION: Midwives are frequently confronted with ethical dilemmas and require guidance in addressing them. This study investigates Lebanese midwives' recognition of and perception of ethical dilemmas in clinical practice, examines influencing factors and explores the role of internal policies and ethics committees. METHODS: Lebanese midwives who graduated between 2017 and 2021 and were registered in the Lebanese Order of Midwives participated in this qualitative and quantitative survey. In September 2022, three online focus groups were held via Zoom with sixteen participants answering validated questions. A quantitative survey was carried out Between October and December 2022. RESULTS: A total of 147 midwives completed the questionnaire. The most frequently reported ethical dilemmas involved disagreements within the team and with patients or families, followed by challenges related to patient autonomy. Among the ethical dilemmas studied, disagreement with patient or family, patient autonomy, and restrictive and hierarchical institutional regulations were found to be significantly associated with the support person sought by the midwives (p = 0.015, p = 0.037, and p = 0.045, respectively). The presence of an ethics committee was significantly associated with reliance on "moral perception and judgement" as a means of coping with ethical challenges (p < 0.001). CONCLUSION: Lebanese midwives regularly face ethical dilemmas, notably disagreements and patient autonomy issues. The presence of an ethics committee significantly aids their moral judgement, highlighting the need for institutional structures that guide ethical practice.
In this article I aim to paint a novel picture: that parents who birth children with lives worth living are cases of moral good luck. To do this, I paint the standard picture of moral luck, and then extend this to show t...In this article I aim to paint a novel picture: that parents who birth children with lives worth living are cases of moral good luck. To do this, I paint the standard picture of moral luck, and then extend this to show that childbirth is, in essence, an exercise in moral luck. I refer to this as the Parental Gambit. In reflecting about how ex ante knowledge informs our biases in evaluating the deontic status of moral luck cases, I posit the Resultant Moral Luck Asymmetry of Parenthood, which states that a parent remains blameworthy if their child turns out not to have a life worth living but is not praiseworthy if their child turns out to have a life worth living. I consider possible counterarguments against my account towards the end of the paper.
Health equity is a primary principle of healthcare delivery, aiming to ensure that all healthcare recipients have access to quality healthcare equally, regardless of their social, demographic, and economic characteristic...Health equity is a primary principle of healthcare delivery, aiming to ensure that all healthcare recipients have access to quality healthcare equally, regardless of their social, demographic, and economic characteristics. The current paper explores the role of nurses in advancing healthcare equity and quality of care. A scoping review was conducted to investigate the relevant international and national articles in major databases, including CINAHL, MEDLINE, Google Scholar, EBSCO, and SCOPUS, using relevant keywords such as "Health Equity," "Quality of Care," and "Role of Nurses." The review highlighted that, as nurses are the frontline healthcare providers in diverse healthcare settings, their roles extend beyond routine healthcare to incorporate more advanced roles in health education, advocacy, and support services, significantly improving access, quality, and equity in healthcare. Several barriers and issues have limited nurses' impact in reducing disparities, but other strategies could be employed to address them. They include telehealth and school-based health centrer. Nursing professionals are in an exceptional position to be transformative in achieving health equity and delivering good quality and accessible healthcare to all individuals and communities.
The partnership approach is part of a broader shift in healthcare that seeks to empower patients in their own care. Accompanying patients (APs) extend the concept of peer support. They are experienced patients who engage...The partnership approach is part of a broader shift in healthcare that seeks to empower patients in their own care. Accompanying patients (APs) extend the concept of peer support. They are experienced patients who engage directly and individually with new patients, enhancing the partnership model. However, the ethical foundations of this role and the ethical tensions arising from its integration are underexplored. To identify the key skills and values required by APs and the ethical tensions they experience, we conducted a qualitative study based on in-depth interviews with nineteen APs between January and May 2021 in Québec, Canada. Interviews explored motivations, skills, values, and experiences in healthcare institutions. Thematic analysis was complemented by Tannahill's public health ethics framework to interpret the ethical tensions identified. The core values identified for this role were empathy, respect, and altruism. All participants agreed that experiential knowledge was paramount. APs identified independence from healthcare institutions as the key to connecting and developing a trusting relationship with patients. However, they also expressed a need to be part of the healthcare system to ensure the sustainability of their role. Our results show an ethical tension between the philosophical core of APs and their needs to pursue their functions. We conclude that independence and authenticity as an AP is not necessarily incompatible with institutionalization, professionalization, and remuneration. These can be achieved if AP programmes are aligned with the philosophy of patient partnership, structured with flexible criteria, and remain self-regulated.
Ectogestation, also known as Artificial Womb Technology (AWT), is a revolutionary reproductive technology that is poised to be one of the greatest innovations of our time. However, like most novel technologies, the poten...Ectogestation, also known as Artificial Womb Technology (AWT), is a revolutionary reproductive technology that is poised to be one of the greatest innovations of our time. However, like most novel technologies, the potential for egregious harm cannot be ignored. In the United States, a country plagued by racist, heteronormative, capitalistic ideology, ectogestation presents a gateway for the severance of parental rights for Black and marginalized pregnant people. Drawing on key scholarship, we first retell the historical devaluation of Black motherhood through social and legal avenues and then connect these to the disproportionality crisis in the Child Welfare system in the United States. Against this background, we then describe contemporary cases of women who were victimized by the medico-legal system, had their bodily autonomy violated, and had their children removed from their custody. We use these cases to demonstrate that the conditions necessary for ectogestation to be used for fetal removal are already in place. Ectogestation thus, can be used to further the separation of families and the severance of parental rights in marginalized communities. We then offer recommendations for preemptive action to prohibit the misuse of ectogestation should it become available in the future.
Based on an analysis of a case study from a Victorian case of neonatal hypoxic ischaemic encephalopathy (HIE), I want to propose that in some circumstances it would be desirable to have well-regulated legal provisions, s...Based on an analysis of a case study from a Victorian case of neonatal hypoxic ischaemic encephalopathy (HIE), I want to propose that in some circumstances it would be desirable to have well-regulated legal provisions, such as the Groningen Protocol (GP), to hasten the death of newborns with catastrophic health conditions in order to reduce suffering. My argument will take the following form: (1) Neonatal euthanasia in form of withholding all (including natural) nutrition and hydration is already practiced in Victoria and considered legal in circumstances of palliative care. (2) In cases where it is already legally practiced, there are better and worse ways to achieve a good death. Ways that result in less suffering, all else being equal, are morally superior and therefore preferable. (3) Lethal injections that result in a painless, controlled death are better than starvation, because it causes less suffering. Therefore, in cases where death as the palliative outcome is either aimed at or unavoidable, injection of a lethal medication is preferable to slow starvation. In well considered circumstances it should therefore be a legal treatment option and considered best practice.
The law and legal processes have a demonstrable impact on the public-health management and lived experience of people living with blood-borne viruses. However, very little is known about how the legal environment informs...The law and legal processes have a demonstrable impact on the public-health management and lived experience of people living with blood-borne viruses. However, very little is known about how the legal environment informs the experience of chronic hepatitis B or the justiciable issues experienced by people living with and affected by the virus. This article reports on a deliberative consensus process conducted with leaders of hepatitis B-related community organizations in Australia that aimed to identify, characterize, and prioritize the legal issues faced by people in the communities they support. Four priority legal areas were identified in relation to: 1) hepatitis B testing and disclosure; 2) migration law; 3) public health orders; and 4) hepatitis B-related stigma and discrimination. Identifying and describing these areas of law and justiciable issues, and organizing them through a consideration of their urgency, prevalence, and health impacts is a key starting point from which to address the neglect of these issues in current policy and practice, and to support the framing and interpretation of further research with people in affected communities. The results of this deliberative consensus process establish clear priorities for further research and for legal and public health policy, practice, resourcing, and reform.