J Bioeth Inq [JOURNAL]
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200 papers
An Ethical Analysis of Medicalization and Infant Mental Healthcare.
Lim IT
J Bioeth Inq · 2026 Mar · PMID 40982107 · Full text
The field of infant mental health has been met with some scepticism by those who question the role of the mental health professions in this space. In this paper I will consider a possible ethical objection to the extensi...
The field of infant mental health has been met with some scepticism by those who question the role of the mental health professions in this space. In this paper I will consider a possible ethical objection to the extension of medical jurisdiction over infancy and parenting, informed by the critical tradition of medicalization studies. In part I of the paper, I will give particular attention to three potentially harmful consequences of medicalization on infants and their families-the expansion of medical social control, the individualization of human suffering, and the pathologization of human behaviour and variation. In part II, I will provide an ethical defence of infant mental health, addressing the objections raised by a medicalization-based critique. I will conclude in part III that medicalization is not always bad for infants and their families, and that, in the case of infant mental health, there is a mutually reinforcing relationship between medicalization and infant rights claims to the fundamental conditions for pursuing a good life.
Symposium Lead Essay: Plural Perspectives on the Ethics of Artificial Intelligence.
Felman E, Kerridge I, Vered M … +1 more , Komesaroff P
J Bioeth Inq · 2025 Sep · PMID 40982106 · Publisher ↗
Abstract loading — click title to view on PubMed.
Response to: "This is not Judaism": The Actions of the Israeli Government and IDF in Gaza are in Direct Contradiction to the Jewish Ethical Tradition (by Paul A. Komesaroff and Jeremiah Z. Kenner).
Cooper H
J Bioeth Inq · 2025 Sep · PMID 40982105 · Publisher ↗
Abstract loading — click title to view on PubMed.
Remembering the Reviewers.
Javed F, Ahmed ZU
J Bioeth Inq · 2025 Sep · PMID 40971089 · Publisher ↗
Peer review is the cornerstone of scholarly publishing, ensuring the quality and credibility of academic research. As Article Processing Charges (APC) continue to rise, many journals provide only symbolic rewards to revi...
Peer review is the cornerstone of scholarly publishing, ensuring the quality and credibility of academic research. As Article Processing Charges (APC) continue to rise, many journals provide only symbolic rewards to reviewers, such as certificates of appreciation and/or minimal discount vouchers, raising ethical concerns about fairness and the marginalization of scholarly labour. This commentary explores the disparity between the financial gains of journals and the no compensation for reviewers, who are crucial to maintaining research standards. It questions whether the current model appropriately recognizes the reviewer's contributions and advocates for actual compensation structures, including financial rewards, substantial reductions in APC, and professional recognition. Additionally, the article highlights the impact of these inequities on early-career researchers and scholars from less affluent regions, suggesting that equitable compensation could improve the sustainability and efficiency of the peer review process. By addressing these ethical concerns, scholarly publishing can better support the essential work of reviewers while fostering a more just and inclusive scholarly environment.
Presymptomatic Screening for Risks to Children's Mental Health : Ethical Considerations from a European Focus Group Study with Mental Health Professionals.
Jansen SNG, Mulder BC, Boekhold AE
J Bioeth Inq · 2025 Sep · PMID 40952615 · Publisher ↗
The development of presymptomatic screening for risks to children's mental health holds the promise to prevent or reduce the burden of mental disorders by enabling timely preventive actions. However, such screening progr...
The development of presymptomatic screening for risks to children's mental health holds the promise to prevent or reduce the burden of mental disorders by enabling timely preventive actions. However, such screening programmes also raise ethical concerns related to false positive results, increased anxiety, harmful effects on a child's sense of self, and stigmatization. Stakeholders can provide valuable insights into these ethical concerns from their engagement with practice. Therefore, in this study we conducted six focus group discussions with professionals in the child mental health domain (in clinical, educational, or policy settings) to investigate their views on presymptomatic screening and identify ethical considerations. The discussions took place in six European countries. Three main themes were identified: 1) Promises and concerns about screening for risks to children's mental health, 2) Additional considerations about biomarker screening, and 3) Implications for healthcare systems and society. Ethical considerations included the benefits of screening outweighing the harms, informed and autonomous decision-making, the actionability of screening outcomes, stigmatization, and medicalization. Our findings underscore the importance of exercising caution in the development and implementation of presymptomatic screening for risks to children's mental health. Implications for practice and future research are discussed.
Should We Just Prescribe? Ethical Considerations When Using Antidepressants and Benzodiazepines For Emotional Distress.
García-Calderó G, Politi SP
J Bioeth Inq · 2025 Dec · PMID 40952614 · Full text
Prescribing antidepressants and benzodiazepines for patients with emotional distress is a common practice in primary healthcare that raises certain ethical questions. This paper has three aims. First, to describe the mot...
Prescribing antidepressants and benzodiazepines for patients with emotional distress is a common practice in primary healthcare that raises certain ethical questions. This paper has three aims. First, to describe the motivations that lead general practitioners to prescribe antidepressants and benzodiazepines in these cases. Second, to reflect on the ethical implications of such prescriptions based on the four principles of biomedical ethics defined by Beauchamp and Childress (autonomy, nonmaleficence, beneficence, and justice). Finally, to propose some recommendations for the mitigation of the medicalization of emotional distress in primary healthcare. Results show that general practitioners seek to alleviate patients' suffering but their prescribing decisions are influenced by some uncertainties in clinical judgement as well as by systemic factors (patients' pressures, time constraints, and unawareness of resources). Ethical issues arise in relation to the potential for dependence, the questionable long-term benefit of prescriptions, the uncritical fulfillment of patients' expectations, and the impediment to address underlying social issues or to develop patients' capabilities. Clinical consultation should be founded on effective communication between doctors and patients and a holistic care approach that acknowledges the psychological, social, and existential dimensions should replace a merely symptomatic approach. Some strategies to mitigate medicalization are proposed: the promotion of regular monitoring visits with patients and multidisciplinary collaboration, the enhancement of physicians' knowledge about non-pharmacological interventions, as well as the establishment of an evidence-base for the effectiveness of these drugs in the primary healthcare setting.
Towards a Less Ideal Theory About Well-being-The Case of Post COVID Condition.
Gustavsson E, Johnson E, Levi R
J Bioeth Inq · 2025 Sep · PMID 40932654 · Publisher ↗
Post COVID-19 Condition (PCC) is a complex condition presenting significant challenges for patients. Individuals suffering from severe PCC are often assessed in rehabilitation medicine departments or specialized post-COV...
Post COVID-19 Condition (PCC) is a complex condition presenting significant challenges for patients. Individuals suffering from severe PCC are often assessed in rehabilitation medicine departments or specialized post-COVID centres, where their condition is evaluated using the International Classification of Functioning, Disability and Health (ICF). The ICF framework primarily focuses on functional impairments, disabilities, and restrictions in participation, with an emphasis on the concept of "functioning." However, a critical question remains: how does this notion of functioning relate to the well-being of these individuals? This paper explores this issue by examining three fictionalized but typical case studies of PCC patients in relation to two distinct theoretical approaches. First, we engage with theories about well-being from the philosophy of well-being emphasizing the individual's perspective. Second, we explore relational approaches in bioethics and their theoretical underpinnings, which emphasize how people are situated, considering context and relations rather than purely individual conditions. The paper highlights the potential tensions between these approaches while arguing that a more comprehensive understanding of well-being can emerge by integrating insights from both traditions. Through the examination of PCC patient cases, we propose that well-being can be better understood when approached from multiple angles, enriching the understanding of patient outcomes in rehabilitation medicine.
The Ethical Basis of Severity as a Priority Setting Criterion in Healthcare-Egalitarian or Prioritarian?
Juth N, Gustavsson E, Sandman L
J Bioeth Inq · 2025 Sep · PMID 40932653 · Publisher ↗
This article discusses the most plausible moral basis for using severity as a priority setting criterion in healthcare: prioritarianism or egalitarianism. We argue that prioritarianism is superior, since egalitarianism h...
This article discusses the most plausible moral basis for using severity as a priority setting criterion in healthcare: prioritarianism or egalitarianism. We argue that prioritarianism is superior, since egalitarianism has several problems that prioritarianism avoids. We have elaborated three such problems. First, egalitarianism arguably needs a non-equality-based reference level in order to determine the magnitude of severity. Second, it has the problem of irrelevant alternatives: the assessment of the severity of one person's illness varies depending on the condition of other persons, even when their health status has not changed. Third, egalitarianism introduces excessive complexity, as it must explain what aspects of inequality matter, and why, in relation to illness severity. By contrast, prioritarianism has some benefits that egalitarianism lacks: it aligns theoretically with the concept of severity as a priority setting criterion in healthcare, and it explains why we always have a pro tanto reason to improve someone's health without having to rely on other theories. In the end, if equality of health matters, it is arguably not because of its connection to severity.
The Geometry of Language: Understanding LLMs in Bioethics.
Astobiza AM
J Bioeth Inq · 2025 Sep · PMID 40932652 · Full text
In this article, I explored the application of large language models (LLMs) in analysing linguistic colexification and ambiguity within bioethical scenarios. By employing word embeddings derived from LLMs, I constructed...
In this article, I explored the application of large language models (LLMs) in analysing linguistic colexification and ambiguity within bioethical scenarios. By employing word embeddings derived from LLMs, I constructed semantic distance matrices that provide insight into the relationships between key terms in bioethical vignettes. These matrices were used to quantify and visualize the degree of linguistic ambiguity and specificity across different versions of each vignette-those with high colexification (ambiguous language) and those with low colexification (specific language). The approach taken involves encoding words according to their semantic adjacency and representing these relationships geometrically through distance matrices. The resulting matrices reflect the nuanced differences in how concepts are related within bioethical contexts, offering a quantitative method for analysing language use. The study demonstrates that LLMs, by facilitating geometric representations of language, can enhance our understanding of complex ethical dilemmas by systematically addressing linguistic ambiguity. Ultimately, this research contributes to the field of bioethics by providing a computational approach to improving clarity in ethical communication, highlighting the potential of LLMs to inform both ethical decision-making and discourse analysis. LLMs, while not capable of performing speech acts in the full philosophical sense-as human beings do-still serve as powerful tools to analyse and understand bioethical language. This distinction-between performing speech acts and analysing their linguistic features-highlights the unique contribution of LLMs as analytical tools rather than ethical agents.
Is this Judaism? The Question of the Consistency of Israeli Policy and Actions in Gaza with Jewish Thought and Ethics : Part 2: Evidence, Analysis and Conclusions.
Komesaroff PA, Kenner JZ
J Bioeth Inq · 2025 Sep · PMID 40932651 · Full text
There has been much discussion about the tactics used by the Israeli Defence Forces (IDF) and government in the conflict in Gaza following October 7, 2023, which have caused, among other things, systematic destruction of...
There has been much discussion about the tactics used by the Israeli Defence Forces (IDF) and government in the conflict in Gaza following October 7, 2023, which have caused, among other things, systematic destruction of hospitals and schools, the deaths of large numbers of civilians, including women and children, mass starvation, and denial of humanitarian aid. The Israeli government and IDF have sought to justify their actions using ethical arguments, many of which relate to their proclaimed role as the representatives of the Jewish state and of Jewish culture and history. Arguing from the extensive corpus of Jewish ethical thought, extending back thousands of years, this article poses a simple question: Are the above actions by the Israeli government and IDF in Gaza consistent with the ethical tradition of Judaism and the obligations that flow from it? To answer this question, key texts are analysed, especially the Hebrew Bible and the Talmud, and multiple arguments are examined, taking into account the complexities of context and diverse interpretive theories. The paper is presented in two parts, the first discussing the question and methodological issues and the second providing the data and conclusions. We conclude that the alleged acts of the Israeli government and IDF in Gaza are clearly and directly contrary to the Judaic tradition of ethics as it has developed over the millennia. The conduct of the war cannot truthfully be presented in any meaningful sense as representing, or indeed, consistent with, Jewish culture or ethics. These findings have potentially far-reaching consequences, including for the claimed status of Israel as a Jewish state, the relationship between criticism of the government of Israel and the scourge of antisemitism, and the identity of Jewish people both within and outside Israel.
Commercial Impacts on Assisted Reproductive Technology: A Scoping Review.
Wiersma M, Kerridge I, Gallagher S … +7 more , Hammarberg K, Norman RJ, Rombauts L, Savulescu J, Stewart C, Yazdani A, Lipworth W
J Bioeth Inq · 2026 Mar · PMID 40932650 · Full text
Assisted reproductive technology (ART) is a growing global industry, projected to reach $37.7 billion by 2027. Predominantly offered in private healthcare settings, concerns have been raised about the potential negative...
Assisted reproductive technology (ART) is a growing global industry, projected to reach $37.7 billion by 2027. Predominantly offered in private healthcare settings, concerns have been raised about the potential negative impacts of commercialization on ART services. Despite numerous accounts of these impacts, a comprehensive synthesis and critique of arguments are lacking. This scoping review aims to provide a nuanced understanding of commercial impacts on ART by exploring how commercial forces have been identified, studied, and evaluated, and what strategies have been suggested for their management in health-related journals. PubMed, Web of Science, Cinahl, and Scopus were searched between January and July 2023 for articles addressing commercial impacts on ART. Database searches identified 11,873 articles, with 163 articles included in the final review. Commercial impacts on ART were most frequently mentioned in discussions of "add-on" interventions (40/163; 25 per cent of articles). Many articles were critical of commercial impacts on ART; however, several suggested that there may be benefit in the delivery of ART by the private sector. This review offers a number of proposed strategies for the mitigation of potential adverse effects of commerce on ART that may be useful to service providers and policymakers. These include improving patient information, enhancing informed consent processes, and increasing regulatory oversight. The review also alerts us to potential challenges that might arise in the context of regulatory reform and reminds us that enhanced regulation is not universally supported.
Many Ways to Think.
Tversky B
J Bioeth Inq · 2025 Sep · PMID 40932649 · Publisher ↗
Thinking, collaborating, and communication happen through interactions of the body, the mind, language, and things in the world. Actions of the body actively express intention, thought, and emotion. Points of the fingers...
Thinking, collaborating, and communication happen through interactions of the body, the mind, language, and things in the world. Actions of the body actively express intention, thought, and emotion. Points of the fingers and nods of the head can refer to things in the surrounding world. A string of interrelated gestures can represent an environment, a complex system, an arrangement of ideas, a sequence of actions. Those gestures use marks and actions in space to represent thought more directly than words-as do graphics like sketches, maps, graphs, diagrams, and pictures. Seeing or making gestures or graphics can change thought, both in those who view them and in those who make them. Interactions with gestures and graphics and the surrounding world are often internal, invisible, and unique, not in words, and not easily decomposed. Through those interactions, shared and individual meanings emerge and change in real time. These features of human thought present challenges to current multi-modal AI.
Nuanced Public Support for Rationing Treatments by Withdrawing and Withholding Due to Negative Reimbursement Decisions.
Strand L, Sandman L, Nedlund AC … +1 more , Tinghög G
J Bioeth Inq · 2025 Sep · PMID 40928722 · Publisher ↗
When treatments are deemed not to be cost-effective and face non-reimbursement, policymakers in publicly funded healthcare systems may decide to ration treatments by withholding it from future patients. However, they mus...
When treatments are deemed not to be cost-effective and face non-reimbursement, policymakers in publicly funded healthcare systems may decide to ration treatments by withholding it from future patients. However, they must also address a critical question: should they also ration treatments by withdrawing it from patients already having access to the treatment, or is there an ethical difference between withdrawing and withholding treatments? To explore this question, we conducted a behavioural experiment (n=1404), examining public support for withdrawing and withholding treatments in reimbursement decisions across eleven different circumstances. Overall, public support for rationing by withdrawing and withholding was low, with no general perceived difference between withdrawing and withholding treatments. However, when we analysed the different circumstances separately, there were multiple circumstances where withholding was deemed ethically more problematic than withdrawing. Moreover, there was an overall preference for allowing individual assessments compared to ensuring that treatments are equally rationed between different healthcare providers. This result may indicate a preference for procedural fairness compared to outcome fairness. In addition, it was deemed more important to allow for individual assessments and to ensure equal rationing when withdrawing treatments compared to withholding. Overall, these findings reveal nuances in public preferences regarding withdrawing and withholding treatments, challenging the prevailing beliefs that withholding treatments is psychologically easier and ethically less problematic than withdrawing. They also challenge assertions of ethical equivalence between these two rationing approaches. If policymakers want to align their policies with public attitudes, our results suggest adopting a nuanced approach towards withdrawing and withholding treatments, recognizing that public support for ethical equivalence between withdrawing and withholding treatments varies depending on the circumstances.
Bridging the Governance Gap: A Case for an Indigenous Jurisprudential Framework for Genomic and Biobanking Research in Nigeria.
Gbadegesin OA, Akintola S
J Bioeth Inq · 2026 Mar · PMID 40856953 · Publisher ↗
Nigeria's governance of genomic and biobanking research is hindered by inadequate regulatory frameworks that fail to address critical ethical and legal issues, such as data sharing, genomic sovereignty, informed consent,...
Nigeria's governance of genomic and biobanking research is hindered by inadequate regulatory frameworks that fail to address critical ethical and legal issues, such as data sharing, genomic sovereignty, informed consent, and benefit sharing. These governance gaps compromise participant rights, undermine trust, and hinder the equitable management of genetic resources. This study proposes an Indigenous Jurisprudential Framework (IJF) that integrates customary law and stewardship principles to create a culturally relevant governance model for genomic and biobanking research. Customary law, which emphasizes communal ownership and collective decision-making, provides a culturally grounded foundation for research governance, while stewardship principles advocate for the responsible management and preservation of genetic resources. By merging these approaches, the IJF aims to enhance ethical oversight, ensure equitable benefit sharing, and rebuild trust between researchers and participants. The framework also seeks to mitigate the exploitation of genetic resources, strengthen Nigeria's position in global scientific collaborations, and promote sustainable development by aligning research practices with local values. This research, grounded in a systematic literature review, offers a practical, context-specific solution that bridges traditional values with contemporary ethical standards, addressing the governance challenges in Nigeria's genomic and biobanking research. The IJF not only provides a model for Nigeria but also offers insights for other countries grappling with similar governance issues, particularly in regions with pluralistic legal systems and rich cultural traditions.
The Algorithm and the Dying Patient: A Moral Mismatch.
Giordano G, Ceccarelli G, Magnanimi E … +1 more , Alessandri F
J Bioeth Inq · 2025 Sep · PMID 40855391 · Publisher ↗
Abstract loading — click title to view on PubMed.
Institutional Responses to Voluntary Assisted Dying: An Empirical Study in Victoria and Western Australia.
Haining CM, Willmott L, White BP
J Bioeth Inq · 2025 Dec · PMID 40815458 · Full text
Patients seeking to access voluntary assisted dying (VAD) are necessarily at the end of their lives. Hence, they are likely to be concurrently receiving care from institutions (community nursing services, health services...
Patients seeking to access voluntary assisted dying (VAD) are necessarily at the end of their lives. Hence, they are likely to be concurrently receiving care from institutions (community nursing services, health services, palliative care services, and aged care facilities) with different levels of participation in VAD. This article reports on the various institutional approaches to VAD based on eighteen semi-structured interviews with regulators from Victoria and Western Australia, representing fifteen institutions with varying levels of support for VAD. We generated five main themes from reflexive thematic analysis of the interview data: settling on a position; operationalizing a position and determining level of involvement; local policy decisions on specific VAD activities; transparency; and navigating pluralism and accommodating diverse views. Overall, our findings revealed significant diversity in how institutions approached various VAD activities and that an institution's position on VAD (whether it supports it or not) does not necessarily indicate the extent to which it will facilitate access to VAD. These findings may have relevance for institutions seeking to implement (or revise) their approach to VAD and suggest that greater transparency about institutional approaches to VAD is needed to enable people to make informed decisions about where to seek care.
Understanding the Artificial Intelligence Revolution and its Ethical Implications.
Beheshti A, Kerridge I
J Bioeth Inq · 2025 Sep · PMID 40810958 · Full text
Recent artificial intelligence (AI) advancements have precipitated profound ethical deliberations and societal concerns. These developments redefine the parameters of technology's role in our daily lives and challenge ou...
Recent artificial intelligence (AI) advancements have precipitated profound ethical deliberations and societal concerns. These developments redefine the parameters of technology's role in our daily lives and challenge our understanding of ethics in the context of AI-enabled processes. As AI systems become more integrated into various facets of human activity, from healthcare to finance and from social interactions to governance, the ethical implications of these technologies have become increasingly complex and pressing. In this paper, we aim to facilitate the understanding of intelligence and Artificial Intelligence and delve into the transformative impact of the AI revolution on societal norms and ethical frameworks. We spotlight the critical ethical questions and concerns that arise as AI technologies become increasingly embedded in various aspects of human life. We provide a brief overview of ethical strategies in AI development and explore how implementing these strategies can mitigate potential risks, promote responsible innovation, and ensure the alignment of AI technologies with societal values.
Othering, Stigma, and Normalization: A Key Informant Interview Study on Ethical Issues in Alcohol Policy in Australia.
Walker MJ
J Bioeth Inq · 2026 Mar · PMID 40802158 · Full text
Alcohol use causes significant harms and is extensively regulated by governments, but alcohol-related questions are under-explored in public health ethics. To inform future work in this area, I conducted interviews with...
Alcohol use causes significant harms and is extensively regulated by governments, but alcohol-related questions are under-explored in public health ethics. To inform future work in this area, I conducted interviews with key informants from alcohol research and policy work in Australia. Thematic analysis of interviews identified a range of ethical issues that can be categorized under six themes: ethical issues in alcohol research; ethical issues raised by judgements about alcohol use; ethical issues raised by alcohol policies; ethical issues in policy processes; ethical questions about policy aims; and ethical issues in how alcohol problems are defined. The study provides direction for future research on problems that are underexplored in the ethics literature. These include problems arising from the influence of industry in alcohol research and policy, the question of how to develop research and policy without generating stigma, and social justice issues connected to alcohol-related stereotypes and judgements.
Narrative Affordances for Birthing-Selves.
Ağören GC
J Bioeth Inq · 2026 Mar · PMID 40794270 · Publisher ↗
In birth literature, there is a consensus that birth narratives incorporating a strong sense of agency contribute to the person's well-being postpartum and beyond. In this article, I aimed to develop an ecological perspe...
In birth literature, there is a consensus that birth narratives incorporating a strong sense of agency contribute to the person's well-being postpartum and beyond. In this article, I aimed to develop an ecological perspective on the emergence of birthing-self narratives and analyse the restrictions experienced in forming empowering birth narratives from the affordance perspective. The concept of affordance has equipped philosophers with a useful tool to study organism-environment relations and to look beyond dualities such as internal and external, biological and environmental, physical and social etc. I argue that this conceptual framework can be fruitful in understanding the emergence of agency and selfhood during birth. Authentic birthing-self narratives are necessarily rooted in the encompassing birth assemblages and reconceptualizing birth assemblage as a system producing narrative affordances for the birthing-self may contribute (1) to supporting a contextual account of self-experience and agency in birth and (2) to illustrate through birth the complexity of the affordance space in which human organisms develop self-experiences. In this study, I dwell on my research and analyse three birthing-self narratives to illustrate how feelings of a birthing body intra-act with physical, social, institutional, and discursive space to shape affordances for narrating the birthing-self.
Patient and Public Involvement with Forced Migrants: An Empirical Exploration of Ethical Issues.
Inge E, Elmi N, Omar Y … +2 more , Warner G, Kihlbom U
J Bioeth Inq · 2025 Dec · PMID 40794269 · Full text
Patient and public involvement (PPI) with forced migrants can have positive impacts on health research, but empirical knowledge on the ethics of involving forced migrants is scarce. Unsolved ethical issues risk hindering...
Patient and public involvement (PPI) with forced migrants can have positive impacts on health research, but empirical knowledge on the ethics of involving forced migrants is scarce. Unsolved ethical issues risk hindering meaningful involvement and jeopardize the research process, as well as harming the public contributors and causing moral distress. In this article, we aimed to identify ethical issues in PPI with forced migrants and present case examples, based on qualitative data and using thematic analysis, as well as analyse the issues using the ethical principles by Beauchamp and Childress as well as PPI-centred values. The ethical issues identified were "Treating forced migrant public contributors as a vulnerable group can inhibit autonomy"; "Non-inclusive communication strategies can contribute to injustice"; "Regulations around payment risk excluding the most vulnerable from involvement"; "Public contributors risk being excluded from partaking in decision-making," and "If trust is not established, public contributors do not feel safe sharing honest input." Further, we discussed the ethical issues using relational ethics, with a focus on how to conduct PPI with forced migrants in an ethical way.
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