Global Bioethics最新文献

One of the ways that environmental inequalities manifest is through the market economy. Research increasingly shows how the weight of capitalist interests cause disequilibria in nature: these imbalances spread to the welfare of animals and back to humans through socio-economic interactions. One Health recognises this connection as generative of unhealthy environments, but little has so far been said about the morality of balancing conflicting interests between animals and humans for resources and space. This paper focusses on One Health's interdisciplinarity; and provides an alternative research methodology, based on concordance of the "right to science," to analyse ethical collaborations between markets and ecological economies. The argument is illustrated by the financing of space exploration and its cost to the environment. My modest ambition is to enhance the ethical debate of a planetary "eco-" [Greek: oikos "house, dwelling place, habitation"] by connecting health, economies [oikonomia "household management"], and ecology [logia "study of"] to a sense of normative environmentalism.

The equitable distribution of vaccines has emerged as a major issue in pandemic treaty negotiations following the COVID-19 pandemic. Failures in global procurement and distribution have been attributed to ineffective allocation mechanisms and a general lack of cooperation. More than four years after the onset of the pandemic, this article presents a perspective on how to achieve a more equitable global allocation of medical supplies for future pandemics, drawing on the distinction between "ideal" and "non-ideal" schemes of cooperation. We will consider two perspectives: first, improving solutions under current, non-ideal circumstances where non-cooperation dominates in the short and medium term, given the challenges of an uncooperative international landscape; and second, implementing long-term policies that aim at ideal proposals, assuming an increased level of cooperation in the future. This evaluation will address the past successes and shortcomings of the COVAX facility, and also the negotiations on a pandemic treaty led by the World Health Organizations, to better address future pandemics. We will discuss key issues that ought to be of central concern when moving towards more cooperative solutions in the future.

While there is limited practical experience and guidance on post-trial access (PTA) in clinical trials in low- and middle-income countries, the concept of benefit-sharing is firmly established in international ethical guidelines. Few studies have been conducted in sub-Saharan African on PTA despite its importance in distributive justice. This study aims to explore the stakeholders' perspectives on PTA and its feasibility in Ethiopia. An exploratory qualitative study using in-depth interviews was conducted with 22 stakeholders involved in clinical trials study and review. Deductive thematic analysis was used to analyze the data. We found that research participants had limited knowledge on PTA. They opined that both trial participants and communities should benefit from clinical trials and multi-stakeholder collaboration was key in PTA planning and arrangements. However, they were uncertain of PTA feasibility in Ethiopia mostly due to a lack of legislation, regulations and guidelines on PTA and fear of losing sponsors because of increased costs resulting from them being obligated to provide PTA. It was recommended that Ethiopia establishes legislation and guidelines to govern PTA. Multi-stakeholder engagement in PTA planning and arrangements is key for meaningful PTA as the responsibility is shouldered by all parties.

Introduction: Ethical considerations in clinical research extend beyond trial completion, emphasizing post-trial responsibilities to ensure participant well-being, particularly in resource-limited settings. This study explores the perspectives of researchers and Research Ethics Committee (REC) members in Tanzania regarding post-trial obligations and their alignment with key ethical frameworks such as the Belmont Report, CIOMS guidelines, and the Declaration of Helsinki. Methods: A qualitative phenomenographic case study was conducted, including a focus group discussion with 11 REC members from three Good Samaritan Foundation (GSF) institutions with a longstanding research collaboration with international partners world wide. Additionally, in-depth interviews were conducted with purposively selected researchers. Data saturation guided the sample size, and NVIVO 12 software facilitated thematic analysis. Results: Findings revealed significant gaps in post-trial care, particularly in maintaining access to interventions. RECs and researchers face challenges in fulfilling post-trial responsibilities calling for clear guidelines and sustainable post-trial mechanisms in resource poor settings. A disconnect exists between RECs' ethical oversight and researchers' practical realities. Community engagement is crucial for ethical research but is often inadequately sustained. Conclusion: Ethical frameworks must explicitly address post-trial obligations, particularly in low-resource settings. Strengthening communication between RECs, researchers, and sponsors, along with ongoing community engagement, is vital for equitable and sustainable global health research.

The advent of the COVID-19 pandemic has profoundly transformed grief around the world. What are the impacts of context factors regarding the COVID-19 pandemic on dysfunctional symptoms of grief? This is a study with a qualitative approach, integrative review, whose article data collection was carried out in the following databases: Biblioteca Virtual de Saúde (BVS), Portal Brasileiro de Publicações e Dados Científicos em Acesso Aberto (Oasisbr), United States National Library of Medicine (PubMed), Scientific Electronic Library (SciELO) and Web of Science. Thirty-three articles were selected for the analysis. The studies showed different results when the risk factors were detailed individually. However, the pandemic context proved to be a complex element that created vulnerability associated with grieving. Bioethics presents itself as a locus of interdisciplinary discussion for a more profound understanding of the complex specificities and, based on the social and political responsibility of Protection Bioethics to protect vulnerable populations, it is recommended to mental health professionals who intentionally explore the impacts of the pandemic on the grieving process. The suffering of people bereaved during the pandemic must be publicly recognized, offering safe spaces for reception and sharing.

Glucocorticoids are understood to represent useful biomarkers of stress and can be measured in saliva, hair, and breastmilk. The collection of such biosamples is increasingly included in biobank and cohort studies. While collection is considered "non-invasive" by biomedical researchers (compared to sampling blood), community perspectives may differ. This cross-sectional, qualitative study utilising eight focus groups aimed to determine the feasibility and acceptability of collecting ostensibly "non-invasive" biological samples in Malawi. Breastfeeding women, couples, field workers, and healthcare providers were purposively sampled. Data about prior understandings of, barriers to, and feasibility of "non-invasive" biosampling were analysed. Participants described biomaterials intended for "non-invasive" collection as sometimes highly sensitive, with sampling procedures raising community concerns. Sampling methods framed as physically "non-invasive" within biomedicine can consequently be considered socially "invasive" by prospective sample donors. Biomedical and community framings of "invasiveness' can therefore diverge, and the former must respond to and be informed by the perspectives of the latter. Further, considerations of collection procedures are shaped by therapeutic misconceptions about the immediate health-related utility of biomedical and public health research. When researchers engage with communities about biosampling, they must ensure they are not furthering therapeutic misconceptions and actively seek to dispel these.

The Japanese government and medical professionals have negative attitudes toward the provision of prenatal testing and related information due to social concern regarding discrimination against persons with disabilities. However, with the rapid increase in the number of non-invasive prenatal tests, particularly at non-certificated medical facilities, in response to the growing demand from pregnant women, the Japanese government and medical professional associations have enacted radical changes marking an active commitment to the provision of information on these services. While a major justification for these policy changes is to ensure respect for reproductive autonomy and women's self-determination, they may reinforce the concern regarding discrimination. This article investigated the argument that these new policies may reinforce discrimination and examined three objections to this argument. The results revealed that the recent policy changes, particularly for specific fetal traits, may imply a negative belief about people living with the same traits. Consequently, fundamental institutional changes are necessary.

Engaging young people in health research has been promoted globally. We explored the outcomes of youth advisory group on health and research engagement (YAGHRE) in rural Cambodia. In May 2021, the Mahidol Oxford Tropical Medicine Research Unit (MORU) partnered with a local health centre and a secondary school to establish a youth engagement group. Ten students underwent training and led health engagement activities in schools and communities. Activities were documented as field notes and audio-visual materials which underwent content analysis using theory of change supplemented by iterative discussions with YAGHRE members and stakeholders. Five major outcomes were identified: 1. Increased respect. Engagement activities developed based on input from students and stakeholders may have fostered greater respect. 2. Built trust and relationships. Frequent visits to MORU's laboratory and interactions with researchers appeared to contribute to the building of trust and relationship. 3. Improved health and research literacy. Learning new health and research topics, through participatory activities may have improved literacy; 4. Improved uptake of health and research interventions. Health promotional activities and communication with research participants potentially increased the uptake of interventions; 5. Improved community health. YAGHRE's health promotional interventions may have contributed in enhancing community's health.