J Bioeth Inq [JOURNAL]
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200 papers
Reconciling Subsistence Emissions and Prevention in Environmentally Sustainable Healthcare.
Parker J
J Bioeth Inq · 2026 Jul · PMID 42390695 · Publisher ↗
With healthcare systems worldwide committing to reduce their greenhouse gas emissions, policymakers must navigate how to reconcile emissions reduction with the delivery of high-quality care. Two main distributive ideals...
With healthcare systems worldwide committing to reduce their greenhouse gas emissions, policymakers must navigate how to reconcile emissions reduction with the delivery of high-quality care. Two main distributive ideals have emerged to guide a just transition to decarbonized healthcare: subsistence emissions and prevention. The subsistence view holds that healthcare emissions that are necessary to meet a threshold of "enough health" are permissible, while emissions exceeding this threshold should be mitigated. The prevention approach, in contrast, prioritizes the most efficient uses of limited emissions through emphasizing measures to prevent the onset of illness and to promote healthy living. Although both frameworks aim to reconcile pursuing the goals of healthcare with reducing the sector's carbon footprint, their approaches to that end appear to conflict. Subsistence emissions tend to prioritize those below the threshold of enough health, whereas prevention focuses on maintaining health in the already relatively well off. As subsistence emissions offers a compelling strategy for decarbonizing healthcare fairly, the question arises: can it accommodate prevention? This paper argues that these two perspectives can be reconciled by detailing how a subsistence emissions approach can also endorse emissions for measures that prevent individuals from falling below a health threshold.
Why the Social Gradient in Health-Related Behaviour is Unjust : An Unconditionalist Perspective.
Weil-Dubuc PL
J Bioeth Inq · 2026 Jul · PMID 42384289 · Publisher ↗
Lower socio-economic position is consistently associated with a higher likelihood of engaging in health-damaging behaviours, a phenomenon known as the social gradient in health-related behaviour (SGHB). This article exam...
Lower socio-economic position is consistently associated with a higher likelihood of engaging in health-damaging behaviours, a phenomenon known as the social gradient in health-related behaviour (SGHB). This article examines and endorses an unconditionalist view, according to which the SGHB is unjust in all cases because it results from structural injustice. This position is contrasted with a conditionalist view, which holds that the SGHB is unjust if and only if it stems from an unequal distribution of the social conditions normatively required for autonomous health-related choices and that a residual gradient may be justified once these conditions are met. Several influential approaches to health justice fall within this conditionalist framework. Despite their substantive differences, these conditionalist approaches share a deeper normative commitment to evaluative individualism. This foundation supports three critiques of unconditionalism: that it entails health perfectionism, that it neglects individuals as agents, and that it relies on a controversial empirical theory that threatens consensus. The first two critiques are considered unpersuasive, while the third raises genuine theoretical and practical challenges.
Mapping the Representation of Race and Other Health Disparities in U.S. Orthopaedic Journals : A Scoping Review.
Vitkovska D, Wang C, Borole A … +4 more , Tyagi A, Zhang YT, Lamba S, Mittal R
J Bioeth Inq · 2026 Jun · PMID 42377755 · Publisher ↗
Background Although interest in health disparities has expanded across medicine, the extent to which race and other social determinants of health are represented in orthopaedic research is unclear. Orthopaedics has tradi...
Background Although interest in health disparities has expanded across medicine, the extent to which race and other social determinants of health are represented in orthopaedic research is unclear. Orthopaedics has traditionally emphasized biomechanical and procedural outcomes rather than structural or social drivers of inequity. This study maps how race and other determinants-gender, socioeconomic status, geography, and insurance-are represented within U.S. orthopaedic surgery journals. Methods A scoping review was performed following PRISMA-ScR guidelines. Searches in PubMed, Embase, Cochrane CENTRAL, CINAHL, Scopus, and Web of Science (2014-2024) identified orthopaedic publications addressing health disparities. Eligible articles analysed or reported variables such as race, ethnicity, sex/gender, socioeconomic status, geography, or insurance. Two reviewers independently screened and charted data. Results Among more than 180,000 articles across sixty-nine orthopaedic journals, 333 (<0.5 per cent) met inclusion criteria. Race/ethnicity appeared most frequently (94 per cent), followed by sex/gender (77 per cent), insurance (39 per cent), socioeconomic status (29 per cent), and geography (24 per cent). Nearly half of the included articles were published in 2022 or later. Of race-related articles, 58 per cent included race only as a demographic descriptor, while 42 per cent analysed race as a primary focus. Conclusion Despite recent growth, health disparities remain minimally represented in orthopaedic literature, with most studies using race descriptively rather than examining structural inequity. Greater engagement with social determinants is needed to advance equitable musculoskeletal care and uphold core bioethical principles.
Safeguarding Physical and Mental Health Rights in African Conflict Regions: Ethical Responsibilities, Barriers, and Collaborative Efforts.
Obasa AE
J Bioeth Inq · 2026 Jun · PMID 42371369 · Publisher ↗
Armed conflicts in Africa disrupt physical and mental healthcare, yet ethical frameworks guiding interventions remain underdeveloped and rarely grounded in local political, cultural, and global realities. Mental health,...
Armed conflicts in Africa disrupt physical and mental healthcare, yet ethical frameworks guiding interventions remain underdeveloped and rarely grounded in local political, cultural, and global realities. Mental health, chronically underfunded, is further devastated by conflict. This paper advances a human rights ethics approach to safeguarding health rights. Integrating Martha Nussbaum's capabilities approach, John Rawls's difference principle, and the African value of ubuntu, it focuses on mental health while assigning responsibilities to global actors whose economic policies fuel conflict. It reframes destruction of health infrastructure, cultural stigma, and weak accountability as violations of dignity and justice, not logistical challenges. Subsidiarity assigns primary responsibility to local actors; international actors bear a duty of solidarity, including addressing upstream conflict drivers. Restoring mental health services empowers individuals and communities-agency is central to healing. Short-term actions include integrating mental health into emergency responses, scaling community-based care, and launching culturally grounded anti-stigma campaigns. Long-term, resilient health systems and accountability, through the African Court on Human and Peoples' Rights and targeted international measures that avoid civilian harm-can hold violators responsible, even governments. Grounded in a coherent, locally situated human rights ethics, even fragile settings can advance the right to health, affirming dignity and solidarity as non-negotiable in war.
Ibsen's An Enemy of the People and the Ethics of Public Health Disclosure.
Tekiner H, Yale SH, Yale ES
J Bioeth Inq · 2026 Jun · PMID 42371368 · Publisher ↗
Henrik Ibsen's An Enemy of the People (1882) dramatizes a physician's discovery that his town's spa waters are contaminated. His efforts to disclose this danger lead to a collapse of civic support, as the truth threatens...
Henrik Ibsen's An Enemy of the People (1882) dramatizes a physician's discovery that his town's spa waters are contaminated. His efforts to disclose this danger lead to a collapse of civic support, as the truth threatens the town's economic and political interests. Beyond being a literary classic, the play serves as a case study in the ethics of public health disclosure. This article places the drama in the context of nineteenth century medical history and explores why Dr. Stockmann fails to communicate the truth effectively. Drawing on virtue ethics, public health frameworks, and organizational research, we argue that candor alone is insufficient: ethical disclosure requires courage tempered by prudence, solid evidence, community support, reciprocity, and institutional backing. Historical analogues and contemporary lessons show how verification, proportionate remedies, and clear communication channels can turn conflict into protection. In contrast to Stockmann's final solitude, medical ethics must ensure that clinicians who sound the alarm are not left to face opposition alone but are supported in safeguarding the public good, even amid seemingly overwhelming resistance.
Is Unconsciousness the Intention? Physicians' Perspectives on Palliative Sedation Outside Specialized Palliative Care: A Qualitative Study.
Midol C, Rodrigues P
J Bioeth Inq · 2026 Jun · PMID 42340599 · Publisher ↗
Background The principle of double effect is often invoked to interpret clinical intentions in palliative sedation (PS), considering that intended effect may differ from foreseen effect. Despite clarifications, intention...
Background The principle of double effect is often invoked to interpret clinical intentions in palliative sedation (PS), considering that intended effect may differ from foreseen effect. Despite clarifications, intentions concerning patient consciousness remain ambiguous. Moreover, little is known about how non-palliative care specialists understand and apply these intentions. Methods This study aims to explore physicians' intentions regarding PS, with a particular focus on the relationship between their intentions and patients' consciousness. This qualitative study is based on twelve semi-structured interviews with physicians from a university hospital in France. The methodology combined hierarchical evocation, clinical vignettes, and semi-structured interviews. Results The study reveals considerable heterogeneity in physicians' intentions regarding patient unconsciousness. The distinction between intended and foreseen effects was often poorly understood. References to the doctrine of double effect were rare, whereas the principle of proportionality was more frequently acknowledged. Conclusion This study reveals important discrepancies between specialized frameworks and the conceptual models of clinical reasoning. We particularly highlighted the inadequacy of the principle of double effect to enable an explicit evaluation of the ethical significance of induced unconsciousness and proposed a more integrated approach to palliative sedation, grounded in contemporary evidence, and proportionality.
Ethics and Autonomy in Schizophrenia Care : Reflections from a Latin American Perspective.
Navarrete-Ríos G, Rubí-González P, Gatica-Saavedra M … +1 more , Vielma-Aguilera A
J Bioeth Inq · 2026 Jun · PMID 42295548 · Publisher ↗
Bioethics has undergone significant evolution in recent decades, particularly in its application to medical sciences and mental health. Its purpose has been to provide solutions to ethical conflicts that arise in healthc...
Bioethics has undergone significant evolution in recent decades, particularly in its application to medical sciences and mental health. Its purpose has been to provide solutions to ethical conflicts that arise in healthcare. In this paper, we review the principle of autonomy in the context of people diagnosed with schizophrenia. In schizophrenia, the main difficulty people face is the ability to make decisions autonomously. This ability is affected primarily by the fluctuating nature of the symptoms and particularly their impact on cognition and judgement. This paper discusses the aspects of this condition that affect autonomy and how to address them from a healthcare perspective, with a view to avoiding depersonalization and respecting people's right to make decisions about their lives and treatment. Securing these aims proves to be highly complex when a person's consent must be obtained and health conditions prevent them from exercising this capacity. The possibility of establishing a balance between autonomy and obtaining the best possible care is an ethical dilemma that persists in mental health treatment, particularly for people diagnosed with schizophrenia. In this situation, advance directives in psychiatry are a viable mechanism to sustain the exercise of autonomy. However, they are still under-utilized, and some medical teams resist their implementation. In Latin America, their use is more restricted. With this in mind, it is necessary to discuss projections for their use, the requirements for their implementation, and to generate reflection among professionals regarding the bioethical and legal challenges raised by the prospect of incorporating advance directives in the treatment of people with schizophrenia.
Advance Research Directives and Supported Consent in Dementia Research.
Divac N, Samardžić N
J Bioeth Inq · 2026 Jun · PMID 42295547 · Publisher ↗
Obtaining ethically valid consent for clinical research involving persons with dementia remains a persistent challenge, as cognitive decline disrupts traditional models of informed consent based on participant's capacity...
Obtaining ethically valid consent for clinical research involving persons with dementia remains a persistent challenge, as cognitive decline disrupts traditional models of informed consent based on participant's capacity to understand the content and freely decide. As a result, individuals are frequently excluded from research or enrolled through proxy consent that may insufficiently reflect their values and autonomous commitments. Recent ethical and policy debates have increasingly promoted advance research directives and supported decision‑making as means of addressing these challenges and enhancing inclusion. This manuscript examines the ethical roles and limitations of advance research directives and supported consent in dementia research. Based on the concept of precedent autonomy, we maintain that advance research directives have distinctive normative importance in the research setting, where participation may involve risks or burdens without direct therapeutic benefit. At the same time, we critically consider supported decision‑making, identifying ethical risks including undue influence, oversimplification of material information, misinterpretation of assent, and the substitution of supporters' preferences for participants' choice. To address these tensions, we propose a hybrid consent model that integrates advance research directives with supported decision‑making, ongoing assessment of assent and dissent, and procedural safeguards. This model implies consent as a continuous ethical process rather than a single event, balancing respect for prior autonomous commitments with sensitivity to present expressions, and well-being. We suggest that such an approach offers a more ethically defensible and practical framework for dementia research, consistent with rights‑based principles and established research ethics standards.
Brain-Hype and For-Profit Medical Devices.
Vassallo M, Picozzi M
J Bioeth Inq · 2026 Jun · PMID 42295546 · Publisher ↗
Research into the functioning of the human brain is essential both for the biological assessment of the species and for our self-comprehension. However, following the "neuroscientific turn" in several areas of research,...
Research into the functioning of the human brain is essential both for the biological assessment of the species and for our self-comprehension. However, following the "neuroscientific turn" in several areas of research, such as psychology, philosophy, and AI, interdisciplinary collaboration in this area gave birth to an important phenomenon that is still active today: "neuro-hype" or "brain-hype." In this paper, we will inquire about one particular aspect of this widespread phenomenon: for-profit neuro-related products. Due to the lack of a vast and robust literature on the topic, the first aspect of our inquiry will concern products that have two major similarities with our focus topic: they are direct-to-consumer (DTC) health-related products, and they have a certain effect on consumer health. The second aspect of our inquiry will delve deeper into DTC neurotechnology by investigating how such products are advertised on major online platforms. In our analysis, we will consider both supplements and biomedical devices, taking into account their ratings, their cost, how they are made, their patent (if present), and will compare this information with the available research data on such objects or similar ones. Finally, this paper argues that while DTC neurotechnologies democratize access to brain health tools, they frequently fail to align with core bioethical principles-autonomy, beneficence, non-maleficence, and justice. These shortcomings highlight an urgent need for robust regulatory frameworks and ethical guidelines to ensure responsible development, equitable access, and transparent commercialization.
Clinical Practice Guidelines in Surgical Malpractice Litigation: An Analysis of California Trial Court Orders.
Calabrese EC, Cooks J, Babidge W … +2 more , Bismark M, Maddern G
J Bioeth Inq · 2026 Jun · PMID 42268333 · Publisher ↗
Background Clinical practice guideline (CPG) development is a time- and resource-intensive process, yet their uptake may be limited by concerns among clinicians that guidelines could be used against them in malpractice c...
Background Clinical practice guideline (CPG) development is a time- and resource-intensive process, yet their uptake may be limited by concerns among clinicians that guidelines could be used against them in malpractice cases. The role of CPGs in surgical litigation remains unclear. Aim To empirically evaluate how CPGs are used in surgical civil law and determine whether cited guidelines are surgery specific. Methods A systematic review of California Civil Trial Court Orders (Westlaw) was searched for surgery-related cases from 2021-2024. Case dockets were reviewed for guideline-based recommendations in expert testimony and in the Summary of Motion documents. Results A total of 192 cases were reviewed with eighty-three meeting inclusion criteria. CPGs were cited in three of eighty-three surgical malpractice cases (3.6 per cent), none of which were surgery specific. Conclusion CPGs appear to be rarely cited in surgical civil court cases and when referenced, they relate to non-surgical aspects of care. However, their violation may provide courts with decisive grounds for legal deliberation. Further studies evaluating a larger number of settlement cases using insurance company data would be invaluable to fully understand the role of surgical and non-surgical guidelines in shaping surgical medicolegal proceedings.
Correction to: Impact of Mandatory Clinical Ethics Consultation for Neurocritically Ill Patients.
Lin YK, Chen CW, Yeh YS … +4 more , Lin CJ, Huang YW, Lin YC, Sheu CC
J Bioeth Inq · 2026 Jun · PMID 42262453 · Publisher ↗
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The Imperative to Live Fully.
Benammar K
J Bioeth Inq · 2026 Jun · PMID 42262452 · Publisher ↗
How did a philosopher who celebrated eccentricity, eroticism, and excess come to embrace the starkest of normative concepts, the imperative? This essay explores this productive tension in the work and life of Alphonso Li...
How did a philosopher who celebrated eccentricity, eroticism, and excess come to embrace the starkest of normative concepts, the imperative? This essay explores this productive tension in the work and life of Alphonso Lingis (1933-2025), drawing on a philosophical exchange and friendship spanning more than three decades. Lingis adapted Kant's concept of the imperative to argue that we are summoned, before and beyond reason, to accompany the dying, to respond to the elemental forces of nature, and to honour the singular gift of our lives by dedicating ourselves to the task that calls to us. Lingis's thinking resonates with Emmanuel Levinas's grounding of ethics in the vulnerability of the face of the Other, yet he anchored his imperative in deeply personal encounters with strangers who risked everything to save him. This personal and philosophical tribute traces how his extraordinary, unconventional life exemplified his insistence that we are all under an imperative to live fully.
Simulating Life, Challenging the Law: Creation and Responsibility in the Governance of Human Embryo Models.
Soni S
J Bioeth Inq · 2026 Jun · PMID 42262451 · Publisher ↗
Rapid advances in stem cell science have generated stem cell-based embryo models (SCBEMs), multicellular structures derived from pluripotent stem cells that recapitulate key features of early human development without or...
Rapid advances in stem cell science have generated stem cell-based embryo models (SCBEMs), multicellular structures derived from pluripotent stem cells that recapitulate key features of early human development without originating from fertilization. Although the literature also refers to these entities as "human embryo models" or "embryoids," this article adopts the term SCBEM to reflect their stem cell derivation and to maintain terminological precision. Originally presented as an alternative research platform to embryos, SCBEMs are increasingly exhibiting embryo-like structural and developmental organization. Their trajectory raises a familiar ethical warning about scientific creation outpacing responsibility and exposes significant gaps in legal definitions that rely on origin-based criteria (fertilization, cloning, parthenogenesis) instead of functional characteristics and demonstrated developmental potential. This article develops a South African-centred analysis within a comparative frame, arguing for a bespoke governance framework that is principled, proportionate, and adaptive. It proposes: (i) revised statutory definitions that are tethered to potential and organization; (ii) specialist oversight and a national register; (iii) a culture-limit policy that is aligned with resemblance (and distinct from the fourteen-day rule which applies in relation to embryos); (iv) bright-line prohibitions on any reproductive use or transfer into human or animal hosts; and (v) mechanisms for public trust, transparency, and cross-border harmonization. The aim is to enable socially valuable research while closing loopholes that could erode ethics oversight and public confidence. This article clarifies the legal-ethical problem through the lenses of potentiality and developmental resemblance, maps the comparative governance of SCBEMs with lessons for South Africa, and offers a model framework which includes definitions, oversight architecture, culture-limit policy, prohibitions, and transparency that are designed to be future-ready. A doctrinal analysis of primary law and authoritative guidance was adopted, supplemented by comparative review and governance design principles (proportionality, accountability, transparency). Where formal sources are silent, policy-ready rules were derived from best-practice codes and ethics literature.
Why Do the Bells Toll? : How to Understand and Address the Disputes Around Evidence in Support of the Use of Puberty Blockers for Young People with Gender Incongruence/Dysphoria.
Giordano S
J Bioeth Inq · 2026 Jun · PMID 42234279 · Publisher ↗
Disputes around puberty blockers and gender-affirming hormones for transgender and gender-diverse youth (TGDY) are often framed as disputes around evidence. Recent reviews, including NICE (2020) and the Cass Review (2024...
Disputes around puberty blockers and gender-affirming hormones for transgender and gender-diverse youth (TGDY) are often framed as disputes around evidence. Recent reviews, including NICE (2020) and the Cass Review (2024), have characterized the supporting evidence as "remarkably weak," prompting calls for further research and regulatory restrictions. This paper explains why producing more or "better" data is unlikely to resolve these disputes. Drawing on Kuhn's account of paradigms and the theory-ladenness of observation, I show that disagreements in paediatric gender medicine reflect not merely gaps in knowledge but deeper metaphysical and normative divergences about sex, gender, health, human development, and the legitimate goals of medical intervention. What counts as evidence, which outcomes matter, and how findings are interpreted depend on competing conceptual frameworks and value commitments. In this light, the proliferation of studies and continuing dissatisfaction with their results are symptomatic of a paradigmatic crisis, rather than a simple evidentiary deficit. This paper does not deny in any way the value of empirical research. It rather points out that appeals to "evidence" risk obscuring the normative dimensions of clinical judgment. Resolution will depend less on the accumulation of data than on explicit ethical deliberation, clinical experience, and engagement with the worldviews that shape what is taken to be meaningful knowledge. This paper first explains why repeated calls for stronger evidence persist despite a substantial empirical literature, by showing that these calls rest on divergent standards of evidential relevance. Second, it shows that the dispute is paradigmatic and as such cannot be adjudicated by data alone. This paper resolves an apparent impasse in the literature and clarifies the limits of data-driven resolution, with implications for clinical guideline development and evidence review processes.
Information, Access, and Stress: Ethical Insights From Parents' Views on Autonomy in Expanded Prenatal Testing.
Scully JL, Hodgson J, McDougall R … +4 more , Kint LT, Holmes I, Laginha KJ, Newson AJ
J Bioeth Inq · 2026 Jun · PMID 42223556 · Publisher ↗
This study explores parents' perspectives on expanded genomic testing in pregnancy and its implications for reproductive autonomy. We conducted four workshops using dialogue group methodology and involving thirty-three A...
This study explores parents' perspectives on expanded genomic testing in pregnancy and its implications for reproductive autonomy. We conducted four workshops using dialogue group methodology and involving thirty-three Australian parents with recent experience of pregnancy. Participants used a fictional scenario involving prenatal testing to reflect on their own experiences and views. Four interconnected themes were identified: barriers to autonomous testing and choice, the need for guidance and support through the decision-making process, the impact of stress and social expectations on reproductive autonomy, and the importance of information to reproductive autonomy. Participants valued genomic information to help in decision-making and to give reassurance but struggled to comprehend the nature of the information that expanded testing could provide. They relied on trusted healthcare professionals to interpret the meaning of test results but recognized the reality of constraints on healthcare resources. Our findings show that reproductive autonomy in this context is both individual and relational and requires health systems that support values-based decision-making. In an era of expanding prenatal genomic testing, our study highlights the need for a framework for reproductive autonomy that goes beyond information provision, to provide the conditions necessary for genuinely autonomous decision-making.
Impact of Mandatory Clinical Ethics Consultation for Neurocritically Ill Patients.
Lin YK, Chen CW, Yeh YS … +4 more , Lin CJ, Huang YW, Lin YC, Sheu CC
J Bioeth Inq · 2026 May · PMID 42209925 · Publisher ↗
This study aimed to investigate and compare the longitudinal impacts of mandatory clinical ethics consultation (CEC) on resource use and ethical conflicts among critically ill neurologic and non-neurologic patients. It a...
This study aimed to investigate and compare the longitudinal impacts of mandatory clinical ethics consultation (CEC) on resource use and ethical conflicts among critically ill neurologic and non-neurologic patients. It also sought to identify relevant predictive factors and determine family member satisfaction with CEC. This combined retrospective and prospective cohort study was conducted at a tertiary academic medical centre. During the eight-year study period, 1,150 adult patients participated in this study (437 neurological and 713 non-neurological). In both groups, the ICU length of stay and days of ventilator use significantly decreased each year. Secular trends in the incidence rates of ethical conflicts significantly decreased each year in neurological patients. Neurological patients exhibited a greater decrease in resource usage and significantly higher incidence rates of ethical conflicts than non-neurological patients. Family members of both groups expressed high levels of satisfaction and agreed that CEC was beneficial. In the local healthcare context, the implementation of CEC policies may reduce resource usage, ethical conflicts, and improve the knowledge base of CEC and clinical teams, helping them in approaching the distinct issues raised by various patient characteristics. However, these findings should be interpreted with caution as their applicability to other healthcare systems may vary.
A Need for Societal Involvement in Promoting a Culture of Care in Animal Research.
Azilagbetor DM, Shaw D, Geneviève LD … +3 more , Milford A, Gaab J, Elger BS
J Bioeth Inq · 2026 May · PMID 42207244 · Publisher ↗
Evidence shows that people doing biomedical research with non-human animals suffer psychological consequences. A culture of care in animal research demands ensuring the well-being of personnel and research animals, and p...
Evidence shows that people doing biomedical research with non-human animals suffer psychological consequences. A culture of care in animal research demands ensuring the well-being of personnel and research animals, and proposals for ethical oversight, social support, and external interventions to address the psychological burden on personnel are growing. With biomedical research being a public good, and the people involved doing so to advance scientific knowledge for societal health benefits, society bears some responsibility for animal research and could be involved in ways that promote the well-being of research personnel. Society, through citizen involvement initiatives, is increasingly involved in shaping biomedical research more generally, while the animal research community is also committed to greater openness and transparency regarding animal use. These initiatives, in addition to the "citizen responsibility" approach used in criminal justice, can be explored to pursue societal involvement in promoting the culture of care in animal research.
Paediatric Nurses' Decision-Making About CPR in Challenging Clinical Scenarios : Insights From a Cross-Sectional Survey.
Bowdler S, Teus JK, Hui HHY … +4 more , Preisz A, Skowronski G, Kerridge I, McErlean G
J Bioeth Inq · 2026 May · PMID 42207243 · Publisher ↗
This study explored paediatric nurses' decision-making regarding resuscitation in patients with unequivocal signs of death and no Do Not Resuscitate (DNR) order. A cross-sectional survey was conducted between October 202...
This study explored paediatric nurses' decision-making regarding resuscitation in patients with unequivocal signs of death and no Do Not Resuscitate (DNR) order. A cross-sectional survey was conducted between October 2023 and April 2024 across the paediatric wards of four Australian hospitals. Participants were asked to respond to two hypothetical clinical scenarios involving a three-year-old boy and a twelve-year-old girl, both clearly deceased-neither of whom had documented DNR orders. Participants indicated their intended resuscitation plan and reasoning for each scenario. Data were analysed descriptively. All respondents (n = 26) (100 per cent) indicated that they would initiate resuscitation for the younger child, while 84.6 per cent (n = 22) would do so for the twelve-year-old. The absence of a DNR order and perceived duty of care were key reasons for their decisions. Findings reveal ethical, legal, and clinical challenges inherent to paediatric resuscitation decisions. This highlights the need for clearer policies, education, and support to guide determination of when resuscitation is appropriate.
Ethical Principles in Legal Context: Vaccine Mandates During the COVID-19 Pandemic in Australia.
Thomasson A, Williams J, Drislane S … +1 more , Rizzi M
J Bioeth Inq · 2026 May · PMID 42201631 · Publisher ↗
Vaccination is both a clinical intervention and a public health tool, creating an inherent tension between individual rights and collective goods in the context of mandatory vaccination policies. There is an additional l...
Vaccination is both a clinical intervention and a public health tool, creating an inherent tension between individual rights and collective goods in the context of mandatory vaccination policies. There is an additional layer of complexity to this in the context of a significant public health crisis. The law has similarly had to manage the tension between consent and coercion with respect to vaccine mandates. Broadly speaking, "mandatory vaccination" is any policy or directive that makes vaccination a condition of being able to participate in a particular activity or to receive a particular benefit. COVID-19 vaccine mandates were introduced in varying forms in every Australian jurisdiction in 2021. This article explores the extent to which the law grappled with the principles and obligations that stem from the ethical principle of autonomy on an individual level and the countervailing pressure of protecting public health in Australia. Applying the ethical framework set out by the World Health Organization COVID-19 Ethics and Governance Working Group, this article considers synergies between law and ethics and makes the case for a more principled and ethically informed policy approach to vaccine mandates in any future public health emergency in Australia.
Bioethics-in-Science : An Invitation.
Kenis D, Devos I, Hens K … +2 more , Moormann E, Paleri VA
J Bioeth Inq · 2026 May · PMID 42201630 · Publisher ↗
This paper proposes using the term "Bioethics-in-Science" (BiS) to denote and delineate a set of emerging methodological approaches entangling bioethical inquiry directly within scientific practice. Drawing inspiration f...
This paper proposes using the term "Bioethics-in-Science" (BiS) to denote and delineate a set of emerging methodological approaches entangling bioethical inquiry directly within scientific practice. Drawing inspiration from Van Rensselaer Potter's original vision of bioethics as a collaborative bridge between biology and ethics, BiS represents a community of practice aiming to contribute to bioethical inquiry in three key ways. First, it reframes the relationship between ethics and science by treating scientific practice as inherently value-laden and recognizing scientists' relevant ethical expertise. Second, it develops methods-including ethics notebooks, collaborative workshops, and conceptual mapping-which facilitate a shift from mere external evaluation towards continuous ethical deliberation within research environments. Third, it demonstrates how bioethical inquiry can actively contribute to improving scientific practice through the co-creation of knowledge and values. Through case studies from synthetic biology, neurodiversity research, and proteomics, we illustrate how BiS arose from and operates in practice, and examine the challenges of crossing disciplinary boundaries. As such, we position BiS as offering a pathway for bioethical inquiry to move beyond its peripheral position vis-à-vis the sciences and engage meaningfully with the normative dimensions of scientific knowledge production instead, ultimately contributing to both better ethics and science.
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