Ethics, Medicine and Public Health最新文献

{"title":"Bringing death into the conversation: Communication strategies for discussing assisted dying in palliative care","authors":"A. Avakian ,&nbsp;K. Avakian ,&nbsp;A. Singh","doi":"10.1016/j.jemep.2025.101223","DOIUrl":"10.1016/j.jemep.2025.101223","url":null,"abstract":"<div><h3>Background and Objective</h3><div>In palliative care, promoting comfort, dignity, and autonomy often requires sensitive conversations about end-of-life options, including assisted dying. Despite the increasing legalization of Medical Aid in Dying (MAID), many clinicians remain hesitant or underprepared to initiate these discussions. This narrative review clarifies how barriers to these discussions have been identified and integrates evidence-based strategies from interdisciplinary literature. This study examines the ethical imperatives and clinical significance of assisted dying communication and aims to provide practical strategies for clinicians.</div></div><div><h3>Methods</h3><div>A narrative literature review was conducted using PubMed, Scopus, and Google Scholar databases for publications from 2010 to 2025. Search combinations included “assisted dying,” “medical aid in dying,” “physician-assisted death,” “communication,” “palliative care,” “ethics,” and “end-of-life discussion.” Studies were included if they examined clinician–patient communication about assisted dying, associated ethical considerations, or strategies for end-of-life dialogue. Findings were synthesized thematically to identify recurring barriers and communication approaches. This review analyzed previously published data and ethical analyses; no patient or identifying information was used, and ethical approval was therefore not applicable.</div></div><div><h3>Results</h3><div>Findings reveal persistent barriers, including legal uncertainties, cultural and religious sensitivities, clinician discomfort, and limited training in end-of-life communication. Evidence indicates that interdisciplinary team collaboration and structured communication frameworks improve confidence and patient satisfaction. These approaches improved clinician confidence, facilitated alignment of care with patient values, and increased patient satisfaction. Ethical analyses further underscore that avoiding or inadequately addressing assisted dying undermines autonomy and may compromise quality of care.</div></div><div><h3>Conclusions</h3><div>Engaging in open discussions about assisted dying is both a clinical responsibility and an ethical duty in palliative care. Addressing barriers through targeted training and structured communication strategies enables clinicians to approach these conversations with greater confidence and compassion. Such dialogue ensures that patient values and preferences are respected, ultimately fostering more dignified and patient-centered end-of-life care.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"34 ","pages":"Article 101223"},"PeriodicalIF":0.0,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biobanks in open-access scientific research","authors":"A. Valverde ,&nbsp;J.A. González ,&nbsp;F. Sevilla ,&nbsp;M. Calderón-Ferrey ,&nbsp;G. Jiménez ,&nbsp;S. Monge-Ureña ,&nbsp;I. Araya-Zúñiga ,&nbsp;R. González","doi":"10.1016/j.jemep.2025.101222","DOIUrl":"10.1016/j.jemep.2025.101222","url":null,"abstract":"<div><h3>Introduction</h3><div>Biobanks are repositories of biological samples and data used to generate new knowledge through research basic and applied to address societal issues.</div></div><div><h3>Aim</h3><div>This paper analyzes the bioethical principles associated with biobanks and open-access scientific information. <em>Methods:</em> We reviewed bioethical analyses, laws, and regulations on biobanks—facilities storing human or non-human specimens with linked data—and their intersection with open-access practices. We mapped governance, consent, privacy, data sharing, benefit-risk, and justice domains. Ethical constructs guided abstraction. Multidisciplinary searches (PubMed, Scopus, Web of Science, CAB, grey literature) plus cross-references captured sector-specific challenges in veterinary, agricultural, and public-health contexts, informing policy.</div></div><div><h3>Results</h3><div>Various classes of biomedical studies use biological samples and genetic data from donors stored in biobanks. Ethical and legal concerns arise, nonetheless, regarding the operation of these repositories. Biobanks have at their disposal multiple ways of handling and storing biomaterials, for example, genetic information security measures and informed consent. Moreover, an international regulatory framework of biobanks, supports the development of bio-legal standards to regulate these facilities worldwide. Data and biomaterial sharing drives reproducibility and innovation, despite barriers to competition, intellectual property ownership claims, and reduced access to technology in countries with fewer economic resources.</div></div><div><h3>Conclusion</h3><div>Sharing data/biomaterials under beneficence, justice, and honesty speeds reproducibility and innovation. Competition, intellectual property, technology hinder progress; robust governance, consent, privacy, regulation uphold autonomy, trust, and global collaboration for societal benefit. Biobanks, guided by ethical principles and clear established policies, strengthen trust, and promote scientific collaboration and social well-being.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"34 ","pages":"Article 101222"},"PeriodicalIF":0.0,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Male patients appeared in Chinese papers on female diseases","authors":"H. Zhang","doi":"10.1016/j.jemep.2025.101221","DOIUrl":"10.1016/j.jemep.2025.101221","url":null,"abstract":"","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"34 ","pages":"Article 101221"},"PeriodicalIF":0.0,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No elder left behind: embedding ‘Pag-amuma’ in Philippine digital care","authors":"J.C. Colegado,&nbsp;R.P. Colegado","doi":"10.1016/j.jemep.2025.101218","DOIUrl":"10.1016/j.jemep.2025.101218","url":null,"abstract":"","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"34 ","pages":"Article 101218"},"PeriodicalIF":0.0,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colonial transitions in health","authors":"P.-H. Moury","doi":"10.1016/j.jemep.2025.101217","DOIUrl":"10.1016/j.jemep.2025.101217","url":null,"abstract":"<div><div>The challenges of colonial transitions in health interact with epidemiology and philosophy, which are necessary to understand the contexts of health disparities found in the French colonies of New Caledonia and the Antilles developed here.</div><div>Colonialism interact with the global health transitions, including demographic, epidemiological, and climatic transitions, through persistent colonial phenomenon in forms of neocolonialism and post-colonialism. This underscores the necessity of revaluating our relationship with nature and the boundaries of our existing perceptions, calling for an ethic grounded in distributive justice.</div><div>The narrative of epidemiology spans from the practices of colonial physicians to the tenets of modern bioethics, delving into the chlordecone scandal. We explore the contributions of figures such as Frantz Fanon, who combated racism and colonialism, and address ongoing debates regarding the incorporation of race in epidemiological research.</div><div>We underscore the essential incorporation of social inequalities in health, with a focus on intersectionality as a lens for revisiting epidemiology, alongside ecofeminism, the \"One Health\" approach, and art to comprehend the determinants of health.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"34 ","pages":"Article 101217"},"PeriodicalIF":0.0,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is withdrawing and withholding of life sustaining treatment really different from assisted dying?","authors":"A. Impiumi ,&nbsp;C. Dalla Vecchia","doi":"10.1016/j.jemep.2025.101220","DOIUrl":"10.1016/j.jemep.2025.101220","url":null,"abstract":"<div><h3>Background</h3><div>End of life decisions have always been subject of ethical and legal debate. Withholding and withdrawing of life sustaining treatment (WWLST) is a widely accepted practice, while assisted dying, including physician assisted suicide and euthanasia remain ethically and legally contentious in many countries. This review explores the ethical arguments surrounding both WWLST and assisted dying focusing on the Irish and the UK landscape.</div></div><div><h3>Methods</h3><div>A literature review was conducted in April 2021 through PubMed, RCSI library online and government website. Sources included academic articles, legal documents and policy statements.</div></div><div><h3>Results</h3><div>Key ethical distinctions between WWLST and assisted dying center on interpretation, intention, patient autonomy and clinical judgement. Some medical cases in the past could have been interpreted as WWLST or assisted dying depending on how the case was presented. Debates include whether assisted dying and WWLST undergo the same ethical principles, if intention is the only difference between the two and if individual autonomy should be considered a principle that makes assisted dying acceptable or if it should be balanced with societal effects. Legally both Ireland and the UK allow WWLST under specific conditions but prohibit assisted dying. Some European countries like the Netherlands and Belgium allow assisted dying with strict criteria, while Switzerland allows it with comparatively minimal restrictions.</div></div><div><h3>Conclusions</h3><div>Although WWLST and assisted dying can both result in patients’ death, their ethical intent, legal status and procedural underpinning differ significantly. Clarity in these distinctions can help informing medical practice and guiding societal dialogue on end-of-life care.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"34 ","pages":"Article 101220"},"PeriodicalIF":0.0,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145520580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Necrophilia among forensic morgue staff in Bangladesh: Three cases and the enduring concern","authors":"S. Hossain ,&nbsp;S.M.Y. Arafat","doi":"10.1016/j.jemep.2025.101216","DOIUrl":"10.1016/j.jemep.2025.101216","url":null,"abstract":"","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"34 ","pages":"Article 101216"},"PeriodicalIF":0.0,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145520583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"‘Kaulaw’ as moral habitus: reimagining ethical barriers in the Philippines’ HIV Response","authors":"R.P. Colegado,&nbsp;J.C. Colegado","doi":"10.1016/j.jemep.2025.101214","DOIUrl":"10.1016/j.jemep.2025.101214","url":null,"abstract":"","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"34 ","pages":"Article 101214"},"PeriodicalIF":0.0,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145520582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of war on the health system, mental health, maternal health, and other war-related health issues in northern Ethiopia from 2020 to 2025: A narrative review","authors":"A. Tiruneh,&nbsp;T. Yetneberk,&nbsp;D. Teshome,&nbsp;E. Fenta","doi":"10.1016/j.jemep.2025.101215","DOIUrl":"10.1016/j.jemep.2025.101215","url":null,"abstract":"<div><h3>Background</h3><div>In Ethiopia, for the last six years, there has been a war between the federal government and regional forces. The war, which began in the Tigray region, has now significantly affected the Amhara region as well. Currently, there is active warfare in different locations in the Amhara region. The damage from the war could be multi-sectoral, and our interest is to show the damage to health systems, health infrastructure, health services, and the lives of citizens in both regions (Tigray and Amhara). Internal displacement of people, interruption of immunization for the pediatric age group, cessation of chronic illness follow-up, and even limited emergency services have also occurred during the war. Gender-based violence, including rape and transmission of incurable diseases such as HIV/AIDS, has been common during the crisis. Unless peace is secured and the war stopped, the aforementioned problems will continue.</div></div><div><h3>Methods</h3><div>The study follows a narrative literature review approach to analyze the situation and incorporates twenty-five studies that report war-related damage in the two regions from 2020−2025.</div></div><div><h3>Results</h3><div>The damage to hospitals was 82.9% in Tigray and 45.5% in the Amhara region, with many fully or partially damaged during the war. Depression increased from 16% in the prewar period to 25% during the war in the Tigray region, and more than 28,560 people were affected by depression in the Amhara region. Additionally, 271 women were raped in the Amhara region, and 34.4% of them tested HIV positive. Child immunization services and chronic illness follow-up, including diabetes mellitus and tuberculosis, were interrupted or limited during the war.</div></div><div><h3>Recommendations</h3><div>This study recommends that the international community, which works in peace and security, initiate negotiations to stop the continued war and restore health services.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"34 ","pages":"Article 101215"},"PeriodicalIF":0.0,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145520579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sherlock Holmes and Continuous Medical Education","authors":"A. Perciaccante ,&nbsp;A. Coralli","doi":"10.1016/j.jemep.2025.101213","DOIUrl":"10.1016/j.jemep.2025.101213","url":null,"abstract":"","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"34 ","pages":"Article 101213"},"PeriodicalIF":0.0,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145520581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}