Ethics, Medicine and Public Health最新文献

英文中文

Contributions and Limitations of Digital Databases of Artworks for Dermatological Iconodiagnosis: The Example of the Musée Fabre, Montpellier 皮肤图像诊断艺术作品数字数据库的贡献与局限性：以蒙彼利埃的mus<s:1> Fabre为例

Q3 Medicine

Ethics, Medicine and Public Health

Pub Date : 2025-10-22 DOI: 10.1016/j.jemep.2025.101206

C. Déchelette , B. Hillion , A. Perciaccante , P. Charlier

Background

Dermatological iconodiagnosis transfers medical expertise in diagnosis to the analysis of skin abnormalities visible in artistic representations. Initially confined to works exhibited in permanent collections, this practice is now benefiting from the rise of digitization, which has expanded its field of study to include pieces kept in museum reserves and now accessible online. In 2023, a learned society dedicated to this discipline was created: the International Society of Iconodiagnosis (ISI).

Methodology

A corpus of pictorial works from the Fabre Museum's digitized database was compiled using a methodology inspired by the PRISMA recommendations. The inclusion criteria were the time period (1400–1900), encompassing both academic and realistic styles, and the use of pictorial techniques (oil, tempera, oil pastel) that allow for particularly realistic representations of the skin. The analysis was carried out in three stages: preselection of works with iconodiagnosis hypotheses, documentary study of the works' files, and iconodiagnosis examination in situ at the museum by ISI members.

Results

Initially, the queries identified 169 portraits, of which 6 were subject to iconodiagnosis hypotheses. Subsequently, a direct visual examination of the paintings and an in-depth consultation of the Fabre Museum's documentary files were carried out. ISI member confirmed 4 dermatological iconodiagnosis, while 2 initial hypotheses were rejected, attributed to pictorial artifacts or alterations related to the state of conservation.

Conclusion

Preliminary analysis of museum digital databases of permanent collections and museum reserves facilitates the targeted identification of works for dermatological iconodiagnosis. However, limitations related to image quality and the risk of overinterpretation require validation through direct observation in close collaboration with the museum team for consultation of the associated artwork files.

背景：皮肤图像诊断将医学专业知识转化为对艺术表现中可见的皮肤异常的分析。这种做法最初仅限于永久收藏的作品，现在受益于数字化的兴起，数字化已经扩大了它的研究领域，包括博物馆储备的作品，现在可以在网上访问。2023年，一个致力于这一学科的学术团体成立了：国际影像诊断学会（ISI）。法布尔博物馆数字化数据库中的绘画作品语料库采用PRISMA建议启发的方法进行汇编。入选标准是时期（1400-1900），包括学术和现实主义风格，以及使用绘画技术（油画、蛋彩画、油彩），这些技术允许对皮肤进行特别现实的表现。分析分三个阶段进行：具有图像诊断假设的作品预选，作品档案的文献研究，ISI成员在博物馆现场进行图像诊断检查。结果最初，查询确定了169幅肖像，其中6幅符合图像诊断假设。随后，对画作进行了直接的视觉检查，并对法布尔博物馆的文献文件进行了深入的咨询。ISI成员确认了4个皮肤图像诊断，而2个最初的假设被拒绝，归因于图像人工制品或与保护状态相关的改变。结论对博物馆永久馆藏和博物馆储备数字数据库进行初步分析，有利于皮肤病影像诊断中作品的针对性鉴定。然而，与图像质量相关的限制和过度解读的风险需要通过与博物馆团队密切合作的直接观察来验证，以咨询相关的艺术品文件。

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引用次数: 0

Ritual smoke: Rethinking tobacco harm reduction in the cultural context of Philippine indigenous communities 仪式烟：重新思考烟草危害减少在菲律宾土著社区的文化背景

Q3 Medicine

Ethics, Medicine and Public Health

Pub Date : 2025-10-18 DOI: 10.1016/j.jemep.2025.101205

R.P. Malinda, V.N. Pamisaran, G.S. Layocan

引用次数: 0

Everyday ethics in the hospital sector: The case of physician-managers 医院部门的日常伦理：以医师管理人员为例

Q3 Medicine

Ethics, Medicine and Public Health

Pub Date : 2025-10-17 DOI: 10.1016/j.jemep.2025.101204

S. Raytcheva, J. Sebai

Background

Healthcare organizations are undergoing profound structural and managerial transformations that significantly impact the ethical environment of medical practice. This study examines the emergence of situated, everyday ethics at the intersection of clinical responsibility and organizational management.

Methods

A qualitative research design was employed, based on semi-structured interviews with five physician-managers across three public hospitals within a territorial consortium. The data, collected during the first quarter of 2024, were analyzed using interpretative phenomenological analysis (IPA), complemented by critical discourse analysis and membership categorization analysis to uncover implicit norms, values, and identity categories embedded in managerial practices.

Results

The findings highlight four key dimensions of physician-managers’ ethical frameworks:

•
Patient-centered ethics as a primary driver of professional managerial legitimacy and sense of work
•
Expertise is seen as both technical and relational, combining clinical authority with proximity to patients and teams.
•
Recognition and listening deficits generate organizational tensions and a sense of fragilized legitimacy.
•
Team care as a moral priority, where supporting healthcare workers is seen as inseparable from delivering high-quality patient care.

The results reveal how physician-managers act as ethical mediators, negotiating between care values and economic constraints. Moreover, everyday ethics is also emotionally loaded.

Conclusions

This study demonstrates that the ethics of physician-managers is embedded in everyday practices that blend clinical and managerial logics. It emphasizes the need to recognize the relational, emotional, and collective dimensions of managerial roles in healthcare institutions. By illuminating the moral negotiations and tensions inherent in governance practices, this research contributes new insights into the construction of organizational ethics.

医疗机构正在经历深刻的结构和管理变革，这对医疗实践的道德环境产生了重大影响。本研究探讨了在临床责任和组织管理的交叉点出现的位置，日常伦理。方法采用质性研究设计，对一个地区联盟内三家公立医院的五名医生管理人员进行半结构化访谈。研究人员使用解释性现象学分析（IPA）对2024年第一季度收集的数据进行了分析，并辅以批判性话语分析和成员分类分析，以揭示管理实践中隐含的规范、价值观和身份类别。结果：研究结果突出了医生-管理者伦理框架的四个关键维度：•以患者为中心的伦理是职业管理合法性和工作感的主要驱动力•专业知识被视为技术和关系，将临床权威与接近患者和团队相结合。•认知和倾听缺陷会导致组织紧张，以及一种脆弱的合法性感。•作为道德优先事项的团队护理，支持医护人员被视为与提供高质量的患者护理密不可分。研究结果揭示了医生管理者如何扮演道德调解人的角色，在医疗价值和经济约束之间进行协商。此外，日常伦理也充满了情感。结论：本研究表明，医师管理者的伦理融入了临床和管理逻辑的日常实践中。它强调需要认识到的关系，情感和集体层面的管理角色在医疗机构。通过阐明治理实践中固有的道德协商和紧张关系，本研究为组织伦理建设提供了新的见解。

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引用次数: 0

Ethics of clinical research in Jordan: An overview 约旦临床研究伦理：综述

Q3 Medicine

Ethics, Medicine and Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.jemep.2025.101125

N.N. Abdelhadi

Background

Clinical research is crucial in advancing medical science and improving healthcare practices. In Jordan, international regulations have influenced the development of clinical research ethics, yet local challenges and areas for improvement still exist.

Objectives

The review aimed to map the ethical principles and frameworks applied in clinical research in Jordan and to provide recommendations for strengthening clinical research ethics in the country.

Methodology

A comprehensive search of PubMed, Medline, Clinical trials.gov, Google Scholar, Science Direct, ADI, and WHO databases was conducted through March 2025. Studies were selected based on relevance to ethical issues in clinical research, including participant consent, privacy, data protection, and research governance.

Results/discussion

Clinical research ethics in Jordan are guided by international frameworks, but several challenges hinder the effective implementation of these ethical principles. To ensure the highest standards of research conduct, researchers and ethical review committees need enhanced training.

Conclusion/perspectives

There are several opportunities for enhancing clinical research ethics in Jordan. Increasing the capacity and capability of IRBs through regular training and resource allocation can improve ethical oversight. Furthermore, promoting public awareness about clinical research ethics and the importance of informed consent can empower participants to make more informed decisions about their involvement in studies.

临床研究对推进医学科学和改善医疗保健实践至关重要。在约旦，国际法规影响了临床研究伦理的发展，但当地的挑战和有待改进的领域仍然存在。目的该综述旨在绘制约旦临床研究中应用的伦理原则和框架，并为加强该国的临床研究伦理提供建议。方法到2025年3月，对PubMed、Medline、Clinical trials.gov、b谷歌Scholar、Science Direct、ADI和WHO数据库进行了全面检索。研究的选择基于临床研究中伦理问题的相关性，包括参与者同意、隐私、数据保护和研究治理。结果/讨论约旦的临床研究伦理是由国际框架指导的，但是一些挑战阻碍了这些伦理原则的有效实施。为了确保研究行为的最高标准，研究人员和伦理审查委员会需要加强培训。结论/观点约旦有几个加强临床研究伦理的机会。通过定期培训和资源分配来提高审计委员会的能力和能力，可以改善道德监督。此外，促进公众对临床研究伦理和知情同意的重要性的认识可以使参与者在参与研究时做出更明智的决定。

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引用次数: 0

Gas Bagging in Pakistan: A Legal, Ethical, and Public Health Crisis 巴基斯坦的毒气装袋：法律、道德和公共卫生危机

Q3 Medicine

Ethics, Medicine and Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.jemep.2025.101106

M. Khabir, S.A. Wasti

引用次数: 0

Embracing entrepreneurial innovation in medicine: The case for inclusion of entrepreneurship education in medical school curriculum 在医学中拥抱创业创新：将创业教育纳入医学院课程的案例

Q3 Medicine

Ethics, Medicine and Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.jemep.2024.101028

Ibrahim Kolawole Mogaji, Lukman Raimi

引用次数: 0

Enhancing iconodiagnosis methodology and scope 增强图像诊断方法和范围

Q3 Medicine

Ethics, Medicine and Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.jemep.2024.101034

I. Pranoto , H.B. Prasetya , D. Apriatama

引用次数: 0

PEPFAR funding suspension and partial restoration: Public health implications for HIV/AIDS control in developing nations 总统防治艾滋病紧急救援计划资金暂停和部分恢复：对发展中国家控制艾滋病毒/艾滋病的公共卫生影响

Q3 Medicine

Ethics, Medicine and Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.jemep.2025.101060

I. Ali , S.M. Mohamed Abdelbar , M.M. Ahmed

引用次数: 0

Psyche, soul and body: A scoping review on the Greek knowledge about the mental disorders in ancient imperial Rome 心灵、灵魂与身体：古希腊罗马帝国精神疾病知识的概览

Q3 Medicine

Ethics, Medicine and Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.jemep.2025.101082

L. Bottalico , L. Santacroce , S. Topi , I.A. Charitos

The sacred paleo medicine with superstitions and religious ceremonies, applied by shamans and magicians, not only in its organization but also in its therapeutic approach and its interpretative method was the first step for the therapy of mental illnesses. It was part of a mythological system, and its representatives were doctor-priests, who, slowly at the same time, collected clinical and semantic data, paving the way before Hippocrates. To investigate the evolution of such thoughts we extracted data from electronic data banks and ancient books from both public libraries and private collections. The texts of ancient medicine cover an extended period ranging from the “Iππoκρατικό Σώμα” (Corpus Hippocraticum) of the classical period (V-IV century BC) up to the authors of the late classical ages Roman Empire such as e.g., Aretaeus, Celsus, Galen, and others. This work aims to take a journey through the legacy of ancient Greek philosophy concerning the psyche that influenced medicine in Roman Classical age in its diagnosis and therapy for the mentally ill, thus laying the scientific foundations of modern neuropsychiatry.

迷信和宗教仪式的神圣古医学，由萨满和魔术师应用，不仅在其组织上，而且在其治疗方法和解释方法上，是治疗精神疾病的第一步。它是一个神话系统的一部分，它的代表是医生牧师，他们慢慢地收集临床和语义数据，为希波克拉底之前铺平了道路。为了研究这种思想的演变，我们从公共图书馆和私人收藏的电子数据库和古籍中提取了数据。古代医学的文本涵盖了一个很长的时期，从古典时期（公元前v - 4世纪）的“Iππoκρατικό Σώμα”（Corpus hippo克拉底文集）到古典时代晚期罗马帝国的作者，如阿雷泰乌斯、塞尔苏斯、盖伦等人。这项工作旨在通过古希腊哲学的精神遗产进行一次旅行，古希腊哲学对罗马古典时代的精神疾病的诊断和治疗产生了影响，从而奠定了现代神经精神病学的科学基础。

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引用次数: 0

Blockchain and homomorphic encryption for genomic and health data sharing: An ethical perspective 基因组和健康数据共享的区块链和同态加密：伦理观点

Q3 Medicine

Ethics, Medicine and Public Health

Pub Date : 2025-01-01 DOI: 10.1016/j.jemep.2025.101127

S.A. Ahmed , R. Hrzic

Background

Sharing genomic data is crucial for public health research, yet it poses significant privacy risks, necessitating innovative solutions to balance data accessibility with individual protection. This study investigates the ethical dimensions of a hybrid system integrating blockchain and homomorphic encryption for secure genomic data sharing in health contexts.

Methods

We conducted a literature review of studies in MEDLINE and Google Scholar, and used the eight peer-reviewed studies uncovered to construct an in-depth description of the hybrid system. We then assessed its performance in achieving public ethics objectives using a framework derived from published public health ethics principles pertaining to data sharing in public health. The evaluation involved conducting a thematic analysis of the information relevant to each objective from the published studies.

Results

We find that the hybrid system aligns well with tenets of public health ethics, including accountability, fairness, respect for persons, privacy, and public health goals, through mechanisms like transparent record-keeping, secure data access, and privacy-preserving computation. However, scalability poses a major challenge, hindered by computational overhead and insufficient stakeholder comprehension.

Conclusions

Our results imply that while the hybrid system can support data sharing while safeguarding individual rights, its practical implementation is limited without addressing scalability. This study underscores the need to highlight scalability as a fundamental ethical principle in evaluating digital public health technologies.

共享基因组数据对公共卫生研究至关重要，但它带来了重大的隐私风险，需要创新的解决方案来平衡数据可访问性和个人保护。本研究探讨了整合区块链和同态加密的混合系统在健康环境下安全基因组数据共享的伦理维度。方法对MEDLINE和谷歌Scholar上的相关研究进行文献综述，并利用已发现的8篇同行评议研究对该混合系统进行深入描述。然后，我们使用与公共卫生数据共享相关的已发表的公共卫生伦理原则衍生的框架来评估其在实现公共卫生伦理目标方面的表现。评价涉及对已发表的研究报告中与每个目标有关的资料进行专题分析。结果我们发现，混合系统通过透明的记录保存、安全的数据访问和隐私保护计算等机制，很好地符合公共卫生伦理原则，包括问责制、公平、尊重个人、隐私和公共卫生目标。然而，可伸缩性带来了重大挑战，受到计算开销和涉众理解不足的阻碍。结论混合系统虽然可以在保障个人权利的同时支持数据共享，但其实际实施受到限制，没有解决可扩展性问题。这项研究强调，在评估数字公共卫生技术时，需要强调可扩展性是一项基本的伦理原则。

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