Ethics, Medicine and Public Health最新文献

{"title":"Psyche, soul and body: A scoping review on the Greek knowledge about the mental disorders in ancient imperial Rome","authors":"L. Bottalico ,&nbsp;L. Santacroce ,&nbsp;S. Topi ,&nbsp;I.A. Charitos","doi":"10.1016/j.jemep.2025.101082","DOIUrl":"10.1016/j.jemep.2025.101082","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101082"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143716123","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":"Blockchain and homomorphic encryption for genomic and health data sharing: An ethical perspective","authors":"S.A. Ahmed ,&nbsp;R. Hrzic","doi":"10.1016/j.jemep.2025.101127","DOIUrl":"10.1016/j.jemep.2025.101127","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101127"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144168100","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":"Book review: “Rethinking Conscientious Objection in Health Care” by Alberto Giubilini, Udo Schuklenk, Francesca Minerva, and Julian Savulescu","authors":"E.M. Torres","doi":"10.1016/j.jemep.2025.101155","DOIUrl":"10.1016/j.jemep.2025.101155","url":null,"abstract":"","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101155"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522306","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":"End of life and death – dead body in Québec law","authors":"M. Lacroix","doi":"10.1016/j.jemep.2025.101135","DOIUrl":"10.1016/j.jemep.2025.101135","url":null,"abstract":"<div><div>The author will first deal with the moment of death, before discussing the status of human remains in Québec private law.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101135"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144280059","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":"Dispositional moral attribution and association avoidance: Explaining chronic Mpox stigma even after recovery","authors":"S. Davoudpour ,&nbsp;R.O. Salvador ,&nbsp;M.G. Curtis ,&nbsp;A.L. French ,&nbsp;S.G. Hosek ,&nbsp;G. Phillips II ,&nbsp;P.A. Serrano","doi":"10.1016/j.jemep.2025.101151","DOIUrl":"10.1016/j.jemep.2025.101151","url":null,"abstract":"<div><h3>Background</h3><div>Prior research indicates that disease-related stigma (e.g., mpox stigma) tends to perpetuate even after the conclusion of the infection. For instance, HIV stigma remains highly prevalent despite the proliferation of stigma-reducing public health initiatives and campaigns. Perpetuation of these stigmas, especially association avoidance well after recovery, has somewhat confounded scholars and public health officials alike. In this study, using the concept of dispositional moral attribution, we offer an explanation for this perpetuated stigma.</div></div><div><h3>Methodology</h3><div>We developed multiple logistic regression models using data from the mpox substudy of the Keeping it LITE study. This cross-sectional survey was conducted in Illinois, USA in September 2022 and collected the attitudes of 226 sexual minority individuals towards the 2022 mpox outbreak in Illinois.</div></div><div><h3>Results/discussion</h3><div>Findings indicate a significant positive relationship between moral attribution and association avoidance of those who have recovered from mpox. Individuals who believe those with mpox have participated in immoral activities are 4.5 times as likely to avoid association with those who recovered from mpox compared to those who do not associate mpox with immoral activities.</div></div><div><h3>Conclusion</h3><div>We conclude that chronic stigmatization, in the form of association avoidance, is more likely when the stigmatized status of an individual is presumed to be the result of their own immoral behavior. Destigmatization campaigns are encouraged to take this finding into account when framing their efforts.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101151"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144492027","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":"How vaccine-derived poliovirus has questioned the public health response to emerging infectious diseases","authors":"A. Zarzeczny,&nbsp;P. Kahar,&nbsp;V. Weiss","doi":"10.1016/j.jemep.2025.101152","DOIUrl":"10.1016/j.jemep.2025.101152","url":null,"abstract":"<div><h3>Background</h3><div>This review aims to explore the existence of poliovirus from the peak of epidemics to modern resurgences, understand its public health response in polio-endemic countries, and the influence of public perceptions of vaccine-derived polio on its eradication progress.</div></div><div><h3>Methodology</h3><div>A literature search was conducted using combinations of the search terms polio, eradication, vaccine-derived, global, resurgence, Covid-19, and vaccination. A total of 15 articles were included in the review.</div></div><div><h3>Discussion</h3><div>Polio has become overshadowed by recent health issues dominating the interest of public health agencies and the World Health Organization. Endemic countries struggle to eradicate polio as civil conflict, foreign distrust, and public health misinformation have produced a lack of political will to eradicate polio. Furthermore, the militarization of public health has caused eradication initiatives to lose their credibility and has painted humanitarian aid as an ulterior motive. Additionally, countries that are struggling to contain polio are suffering from resource shortages and new health issues prompted by the Covid-19 pandemic. As millions of immunizations were missed during the pandemic, there has been concern for a global uprising of polio following surges of polio cases in both endemic and polio-free countries. Although eradication programs in the past have emphasized the need for programs tailored to communities’ needs and a strong sense of global collaboration, this strategy has been poorly utilized by recent polio programs.</div></div><div><h3>Conclusion</h3><div>Efforts to eliminate polio go beyond acquiring the tools for eradication. Although effective interventions and screening procedures for polio exist, eradication cannot be achieved unless barriers to accessibility and poor political will are addressed. Given this, polio resurgences demand a change in the way polio is perceived by the public as well as a unified global commitment to eradicate polio.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101152"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513572","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":"Overcoming language barriers in pediatric clinical research: A qualitative study of researchers' views","authors":"S. Chhina ,&nbsp;S. Moreheart ,&nbsp;J. Claydon ,&nbsp;B. Udall ,&nbsp;M. Sadarangani ,&nbsp;H. Longstaff ,&nbsp;A. Orth ,&nbsp;Q. Doan","doi":"10.1016/j.jemep.2025.101171","DOIUrl":"10.1016/j.jemep.2025.101171","url":null,"abstract":"<div><h3>Background</h3><div>Limited English proficiency (LEP) can act as a barrier to equitable access to pediatric clinical research participation. This study examined researchers' perspectives on challenges and opportunities for including patients and families with LEP.</div></div><div><h3>Methods</h3><div>Semi-structured interviews were conducted with 26 researchers and hospital leaders at two hospitals in British Columbia, Canada. Interviews explored experiences offering research opportunities to populations with LEP and perceived barriers and facilitators. Thematic analysis was used to analyze interview transcripts.</div></div><div><h3>Results</h3><div>Five themes emerged: 1) lack of translation/interpretation resources; 2) unclear best practices; 3) doubts about translation quality; 4) low prioritization; 5) facilitators. Barriers existed at institutional and individual levels.</div></div><div><h3>Conclusion</h3><div>A comprehensive approach is needed to support equitable participation of patients with LEP in pediatric health research, including increased funding, cultural competence training, community partnerships, and language-inclusive design. Recognizing and addressing multi-level barriers can promote fully representative and equitable research participation for populations with LEP.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101171"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144903860","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":"Bridging worlds: A case-series on cultural challenges for second-generation oncological adolescents with palliative care needs","authors":"A. Santini ,&nbsp;A. Mercante ,&nbsp;A. Marinetto ,&nbsp;F. Benini","doi":"10.1016/j.jemep.2025.101177","DOIUrl":"10.1016/j.jemep.2025.101177","url":null,"abstract":"<div><div>The role of the child and family’s cultural dimension in influencing healthcare experiences and outcomes has been increasingly recognized in pediatric palliative care (PPC). Therefore, a culturally sensitive project of care is essential to allow the person-centered, holistic, and tailored approach that characterizes PPC. However, this is not always easy.</div><div>Second-generation immigrants have a unique social and cultural background and may face numerous challenges in balancing their bicultural identity. This report explores the complexities associated with shared decision-making and individual care planning within the realm of PPC across diverse cultural contexts. It employs an illustrative case series to emphasize the need to build bridges between different cultures within which the young person lives and finds balance.</div><div>Serving as intermediaries for their families, they often endure uncomfortable and demanding roles, which results in a diminished awareness of their personal needs and concerns. Clinicians generally find it more effective to engage directly with the adolescent rather than with their parents, often presuming that the parents share values and beliefs similar to those of their child. However, such assumptions may overlook significant cultural and generational disparities.</div><div>Delivering comprehensive support to adolescents within these dynamics is imperative, as it assists them in managing their intricate roles and navigating cultural disparities. Concurrently, enhancing clinicians’ awareness of these dynamics is vital for promoting a more culturally competent approach to care. This discourse emphazises strategies for effective communication and bridging cultural differences, outlining implications for practice and policy in multicultural environments.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101177"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144903861","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 ethics of exposure: Relational bioethics, responsibility, and systemic failure in psychiatry and mental healthcare","authors":"P. Scognamiglio ,&nbsp;D. Morena","doi":"10.1016/j.jemep.2025.101189","DOIUrl":"10.1016/j.jemep.2025.101189","url":null,"abstract":"<div><h3>Background</h3><div>This study examines the ethical, institutional, and legal factors influencing psychiatric care in Italy, highlighting how systemic fragmentation, chronic underfunding, and increasing medico-legal liability contribute to moral distress among clinicians and the adoption of defensive psychiatric practices. The objective is to assess the impact of these factors on both patient outcomes and the capacity of healthcare professionals to deliver effective and ethically sound care.</div></div><div><h3>Methodology</h3><div>Using a qualitative, narrative-based, and reflexive methodology, the paper draws on the testimonies of the authors and a series of anonymized clinical narratives, including but not limited to cases of suicide. These accounts were selected for their paradigmatic value in revealing structural dynamics, rather than for statistical representativeness. The analysis combines narrative ethics and relational bioethics to examine how systemic vulnerability manifests in everyday psychiatric practice.</div></div><div><h3>Discussion</h3><div>Fear of litigation and institutional abandonment can significantly influence clinical judgment, resulting in excessive control measures, procedural overreach, and emotional exhaustion among healthcare professionals. Defensive practices – such as over-hospitalization, over-prescription, and hyper-documentation – arise not from negligence but as adaptive responses to institutional fragility.</div></div><div><h3>Perspectives</h3><div>The study offers three key contributions. First, it recalls the One Health paradigm as the only viable framework for bringing together mental healthcare and institutional ethics, highlighting the need for interdependent and ethically sustainable systems of care. Second, it situates the Italian case within a broader reflection on the erosion of meaning in mental health practice within systems that demand total accountability without offering protection to their professionals. Finally, it calls for institutional architectures capable of sustaining both clinical presence and shared responsibility.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101189"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145026748","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":"Care and support for the elderly in France: Major managerial challenges","authors":"C. Pascal","doi":"10.1016/j.jemep.2025.101161","DOIUrl":"10.1016/j.jemep.2025.101161","url":null,"abstract":"<div><h3>Background</h3><div>France, like many other developed countries, is experiencing a significant demographic transition marked by an ageing population. This shift has resulted in a growing demand for care and support services for older people. In response, the French government has implemented several policy measures, including the promotion of home-based care and the development of coordination support systems, in an effort to maintain autonomy and contain costs.</div></div><div><h3>Objectives</h3><div>This article aims to identify and analyze the main managerial challenges that elderly care institutions and services in France must address to adapt to the changing healthcare and social landscape.</div></div><div><h3>Methods</h3><div>The analysis is based on a selective review of recent French official reports and peer-reviewed scientific publications related to elderly care policies, service organization, and workforce management.</div></div><div><h3>Findings</h3><div>Five major managerial challenges are identified:</div><div>- Strategic human resources management – The sector faces severe workforce shortages, particularly among nurses and care workers, due to low pay, difficult working conditions, and limited career prospects.</div><div>- Operations management and planning – Rising costs associated with increasing care needs, real estate expenses, and regulatory requirements necessitate enhanced efficiency and procurement strategies.</div><div>- Organizational memory – High staff turnover risks eroding institutional know-how and calls for procedural reinforcement to sustain quality and safety in care delivery.</div><div>- Care pathways – While public authorities seek greater coordination and integration of health and social services, operationalising this ambition remains difficult due to institutional fragmentation, ambiguous responsibilities, and a lack of shared tools and data.</div><div>- Transportation and mobility – The limited mobility of frail older adults complicates their access to healthcare and support services. This challenge is exacerbated by rising energy costs and environmental policies aimed at reducing car travel, which constrain traditional models of transportation. While e-health solutions offer promising alternatives to in-person care, their deployment requires a broader reconfiguration of service delivery models and associated economic structures.</div></div><div><h3>Conclusion</h3><div>Elderly care services in France must navigate multiple structural and operational challenges to adapt to demographic and systemic changes. Addressing these issues requires strategic investment in workforce development, service coordination, and innovation in care delivery mechanisms.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101161"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048292","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}