Global Bioethics最新文献

Climate change, ecological degradation and global inequalities are symptoms of an eco-social polycrisis that threatens global health and health equity. This polycrisis is deeply rooted in Western value systems. These can be described as anthropocentric and individualistic and support the prevailing neoliberal economic model. Bioethics is now called to respond to the urgent health-related ethical challenges of the polycrisis and has recently begun to engage with Planetary Health and One Health in this regard. Both have mainly emerged in the Western scientific community and understand human health to be inextricably linked to the state of environmental and structural societal determinants. We argue that bioethics should indeed embrace holistic or integrated understandings of health but also carefully revisit the foundational Western value systems at the root of the polycrisis. If Planetary Health and One Health stay grounded in Western value systems, an extensive conceptual engagement might be problematic for bioethics. Instead of turning to Western concepts of health, bioethics should engage deeply with Indigenous and non-Western ways of knowing and critically reflect on its own role in inadvertently maintaining the status quo.

This paper explores the application of the One Health approach through an analysis of the response to the 2007 crisis in Chile's salmon aquaculture industry. To evaluate the extent to which the case aligns with a "minimal" One Health framework, we draw on four key dimensions of this framework (methodological, epistemic, ontological, and ethical) and contrast the case with the response to the 2009 Q fever outbreak in the Netherlands. We conclude that the Dutch response to Q fever, characterized by limited institutional collaboration, a narrow disciplinary focus, and an anthropocentric ethical stance, fell short of even a minimal One Health approach. In contrast, the response by the Aquaculture Health Management Program (PGSA) to Chile's salmon aquaculture crisis represents a more integrated approach, involving multisectoral collaboration, interdisciplinary dialogue, and concern for animal and environmental health. While the Chilean case does not fully achieve a strong One Health model, it demonstrates the practical benefits of adopting a minimal One Health perspective, including reduced antibiotic use and improved disease control. The paper concludes that One Health should be understood as a flexible, problem-solving framework, and that clarity regarding its core dimensions is essential for strengthening One Health approaches.

The ethical complexities of technological advancement are growing as fields such as climate adaptation, microbiology, healthcare, robotics, and artificial intelligence (AI) evolve rapidly. While these technologies offer innovative solutions to global challenges, they raise significant ethical concerns. In climate adaptation, AI-driven models and remote sensing technologies prompt questions about data privacy, environmental justice, and equitable access, especially for vulnerable populations. Similarly, advancements in microbiology and healthcare, such as genetic research and digital health tools, present ethical dilemmas related to informed consent, data security, and the exploitation of marginalized communities. In robotics and AI, ethical concerns are heightened due to their potential to automate decision-making, affect employment, and infringe on personal freedoms. The influence of AI in healthcare, law enforcement, and public services highlights the urgent need for ethical oversight to prevent bias and protect human rights. The EU AI Act addresses these challenges by categorizing AI systems by risk and setting stringent guidelines for high-risk applications, especially in sensitive sectors like healthcare. This article emphasizes the importance of balancing innovation with ethical responsibility, advocating for comprehensive regulatory frameworks, interdisciplinary collaboration, and global cooperation to ensure that technological advancements align with ethical standards and societal values.

Verbal autopsy research is vital for understanding community mortality, informing health interventions and policies in low- and middle-income countries. However, overlooking the community perspectives on deaths can undermine the ethical conduct and effectiveness of such research. This study explored community-based concepts of death, interpretations, and coping mechanisms in five Southeast Asian countries, with this manuscript highlighting key findings from the body mapping exercise that revealed diverse cultural and religious understandings on death. Participants' views ranged from seeing death as a cessation to life's struggles to an inevitable end, reflecting deep cultural and spiritual beliefs. Coping mechanisms, often grounded in religious practice and community support, played a crucial role in managing grief. The study also underscores the importance of addressing emotional well-being for both participants and researchers. Recommendations include integrating mental health support into research protocols and tailoring practices to local cultural contexts. These findings inform the design of more ethically grounded verbal autopsy tools and procedures that are sensitive to local beliefs and emotional dynamics, ultimately improving data quality and community trust.

This article explores the relationship between zoonotic outbreaks and the interconnected nature of globalization through the lens of the One Health framework. It argues that global ecological changes driven by climate changes, deforestation, intensified agriculture, wildlife trade, and urban expansion have significantly elevated the risk of zoonotic disease transmission. It emphasizes how globalization has intensified some of the factors that contribute to the emergence of zoonotic outbreaks, and has also facilitated the spread of infectious diseases. Drawing on recent examples, such as the emergence of H1N1, COVID-19 and Nipah virus outbreaks, the article emphasizes the need for robust, interdisciplinary collaboration among human, animal, and environmental health sectors. The article advocates for a comprehensive global strategy rooted in the One Health approach to mitigate future zoonotic threats. It argues that this approach is based on an ethical principle of solidarity, which refers to the enacted commitment to support others based on the recognition of shared vulnerabilities or similarities. This principle is essential for collective responses to global challenges like zoonotic diseases. The One Health approach requires reinvesting in multilateral governance, enhancing wildlife and livestock surveillance, and addressing socio-environmental drivers of disease emergence, thereby promoting planetary health and global biosecurity. However, it also highlights the vulnerabilities created by nationalistic and populist policies, based on a distrust of multilateral organizations and international cooperation, and that have underfunded global health institutions, particularly affecting low-resource regions where early detection systems are lacking.

Cervical cancer screening remains limited in developing countries due to barriers such as lack of convenience and privacy. These challenges hinder both screening uptake and the process of obtaining informed consent. This study aimed to explore ways to address these barriers and support ethical participation in screening research. The study was conducted in three rural and one urban kebele in Butajira, Southern Ethiopia. A total of 58 participants - including community elders, religious leaders, women's representatives, and traditional association leaders - were selected through purposive sampling for focus group discussions and in-depth interviews. Two interview guides were used to explore consent, decision-making, and screening preferences. Data were analysed using qualitative content analysis via QCAmap software. Participants generally understood the concept of voluntary participation but emphasized the need for clear communication about benefits. Although women could decide independently, many noted the importance of involving husbands. Initial suspicion about written consent was addressed through trust-building. A strong preference emerged for female providers during consent and procedures to enhance comfort. Self-sampling raised concerns about technical difficulty and cultural norms. Addressing cultural and ethical concerns is vital for improving cervical cancer screening participation. Insights from this study should guide future research and interventions in similar settings.

In this short analysis, we argue that while One Health approaches have remained anthropocentric (i.e. morally and practically prioritizing human health), One Health is due for its "Jurassic Park moment." Such a moment would mark a shift in moral priority, balancing human interests against nonhuman interests. Examples of theory and practice in One Health support the potential for such a shift.

Dementia is responsible for untold suffering, most significant is the fear that someone will lose themselves. This fear raises very serious pastoral questions: Who is the person living with dementia? Are they the same person they have always been or someone new? In either case, how do we treat them? Using the well-known case of Margo and the discussions between Dworkin and Dresser around advanced care directives, this article radically challenges the standard psychology view of personhood as being pastorally unhelpful in dementia cases. We argue that a relational view of personhood is not only epistemologically consistent but better suited to the pastoral challenge presented by dementia than that of the standard psychological view. While dementia represents the loss of cognitive abilities, and in many cases an entire change in personality, it does not represent either the loss of a person nor a change of personhood. Through dementia a person remains a person because they are personally related to by the same community of persons who have always loved them. This normative framework offers those living with dementia, their community, and their carers with a coherent, yet pastorally helpful response to the existential questions raised by dementia.

Synthetic Biology (SynBio) is a rapidly advancing interdisciplinary field that holds immense potential to address pressing global issues, including food insecurity, medical innovation, and environmental sustainability. Yet, the ethical discourse surrounding its development has often struggled to keep pace with its scientific progress. This stagnation, I argue, arises largely from the persistence of dualistic frameworks - such as "natural" versus "artificial" or "human" versus "machine" - that dominate bioethical inquiry. These dichotomies limit the scope of moral reflection and hinder the development of more holistic ethical frameworks. This paper seeks to reframe these debates by drawing upon the non-dualistic worldview of Sanātana Dharma, the foundation of Indian Hindu philosophy. Through this lens, I propose a different perspective that emphasizes interconnectedness, responsibility, and reverence for all forms of life, natural and synthetic alike, offering a more inclusive and holistic approach to evaluate emerging biotechnologies.

In the public healthcare system, personal autonomy has rightly become a key element of health politics. Nevertheless, conflicts can arise when the interests of a caring welfare state collide with the decisions of those in its care. In such cases, the concept of autonomy as a fundamental ethical principle can cause harm, if solely interpreted as freedom from interference by the public sector, devoid of demands on personal responsibility. Based on the example of vaccine hesitancy during COVID-19, we propose that resolving these conflicts should integrate two divergent basic tenets of autonomy, as developed over time, and recently applied disjunctively to the pandemic by ethicists, so that the principle can be consistently operationalised as a function of an open but also binding argument within society. This may have implications far beyond SARS-CoV-2. We touch on philosophical grounds where the assertion of axiomatic moral rights is replaced by an epistemological framing of the deliberation process as a ubiquitous and not merely representative argumentative act, while validity claims are individually redeemed in a dialogical balancing of reasons and objections. Recognising this as the humanistic core of healthcare calls for an expansion of the state's communicative obligations but also implies proportionate paternalism.