Ethics, Medicine and Public Health最新文献

{"title":"Mapping the global landscape of public health policy research: A bibliometric study based on Scopus data (2000–2024)","authors":"I.M.A. Yudantara","doi":"10.1016/j.jemep.2025.101190","DOIUrl":"10.1016/j.jemep.2025.101190","url":null,"abstract":"<div><h3>Background</h3><div>Global public health policy research has evolved more slowly compared to other health domains. Despite the continuous growth of health literature, a comprehensive bibliometric mapping of the global landscape of public health policy research remains unavailable, particularly regarding geographical disparities and collaborative networks.</div></div><div><h3>Methodology</h3><div>This study conducts a systematic bibliometric analysis of 501 public health policy research publications using Scopus data from 2000 to 2024. Bibliometric techniques such as keyword co-occurrence analysis, thematic mapping, and network visualization are employed to identify growth patterns, geographic distribution, thematic evolution, and collaboration networks.</div></div><div><h3>Results/Discussion</h3><div>The analysis reveals three developmental phases: \"risk\" focus (2000–2007), \"access\" emphasis (2008–2015), and integrated \"health\" approaches (2016–2024). Publications demonstrate significant growth (19.26% annual growth rate) with a surge after 2020. The United States and the United Kingdom dominate, while network visualization uncovers a persistent \"core-periphery\" structure.</div></div><div><h3>Conclusion/Perspectives</h3><div>Findings highlight productivity disparities between developed and developing countries, underscoring the need for enhanced research capacity in underrepresented areas and more equitable collaboration networks. Future directions include expanding data coverage, applying more sophisticated social impact metrics, and investigating informal knowledge transfer mechanisms to inform more effective and equitable global public health policies.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101190"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048290","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":"Redefining biological weapons in the evolving AI, CRISPR, and biothreat landscape","authors":"Hazem Haddad","doi":"10.1016/j.jemep.2025.101176","DOIUrl":"10.1016/j.jemep.2025.101176","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;In 2025, the Biological Weapons Convention (BWC) and the United Nations Office for Disarmament Affairs (UNODA) will turn 50 years old. Every one of the BWC’s 189 States Parties will decide whether to give the treaty its first real upgrade and make it future-proof.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;The biothreat posed by state and non-state actors has evolved with the democratization of synthetic biology and genetic engineering including clustered regularly interspaced short palindromic repeats (CRISPR) and gain-of-function research, artificial intelligence (AI), and 3D bioprinting. Combined with algorithms applied to genomic databases, these technologies have revolutionized biological agent modification and the delivery or dissemination vectors for the biological weapon system in line with potential biowarfare objectives. Infections, outbreak-scale disasters, or large-scale health security incident scenarios are forecasted and explored by AI using global and parallel genomic databases that feed AI prediction outcomes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;The traditional definition rooted in the Biological Weapons Convention of 1972 primarily focused on microorganisms, toxins, and their means of delivery intended for hostile purposes, Article I. However, biotechnology’s rapid advancement and diffusion have blurred the lines between defensive and offensive research, creating opportunities for both state and non-state actors to develop and deploy novel bioweapons.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;This paper contends that a contemporary definition of biological weapons must encompass any biological agent, technology, or knowledge with the potential to cause harm to humans, animals, or the environment when used for malicious purposes. Such a definition acknowledges the dual-use dilemma inherent in biotechnological advancements. To address these evolving threats, this paper proposes a multifaceted approach centered on strengthening international norms, fostering responsible innovation, and enhancing global collaboration and a reevaluation of the definition of biological weapons and the international frameworks designed to prevent their misuse and the lessons from the historical progress of bioweapons and bioterrorism from ancient times to the present has been studied in terms of developments in the technology and understanding of the Biothreat processes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;The redefinition of biological weapons considering technical advances from different regions' committees is not purely an academic or public health exercise but an urgent imperative for defending global health and security as Framework of New Definition of Biological Weapon Map of the proposed new definition of Biological Weapon links new modern technology AI with genome database of Humans, Animals, Plant, Pathogen, environmental health, and Climate Change come in one body under combines multiple international, governmental","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101176"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157414","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":"Short report: UNESCO's role in bioethics - From the country level to the international conversation in bioethics","authors":"M. Stanton-Jean","doi":"10.1016/j.jemep.2024.101030","DOIUrl":"10.1016/j.jemep.2024.101030","url":null,"abstract":"","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101030"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143098533","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 power relations impact pregnancy and childbirth: Knowledge, Healthcare and Work in France","authors":"E. Boulet ,&nbsp;R. Guilloux","doi":"10.1016/j.jemep.2024.101032","DOIUrl":"10.1016/j.jemep.2024.101032","url":null,"abstract":"<div><div>Based on a constructivist approach to human reproduction, this focus analyses the ways childbirth in mainland France is framed by natalist and health policies and by social inequalities. Beyond the tension between naturalness and technicality, birth is subject to a diversity of power relations. We focus here on power dynamics around class, sex and race, which impact the access to and the quality of perinatal care. Drawing on qualitative and quantitative studies, we show that women and couples have unequal access to information during pregnancy, for several reasons. Firstly, the standardised length of antenatal consultations. Secondly, differences in understanding of information that is implicitly adapted to the most educated and affluent social classes. Thirdly, the ambivalence of the information, which oscillates between autonomy and injunction in terms of how the baby should be delivered and fed. Fourthly, pregnant workers have little knowledge of their reproductive rights. We also show that the provision of perinatal care is unequal despite a supposedly universal health insurance system. Racially minoritized women are subject to more complex administrative procedures and to more medical interventions. In addition, health and diet recommendations, and alternative birthing methods, are better suited to the individualistic logic and material conditions of the middle classes than those of the working classes. As far as working conditions are concerned, women in arduous occupations use sick leave as a means of protection, whereas women in less arduous occupations take maternity leave later than the other women. Lastly, men's involvement in domestic tasks during women's pregnancies remains occasional and limited to the physical dimension of those tasks, even more so as the assignment of women to domestic labour is reinforced by healthcare professionals. Finally, we contend that equal care for all pregnant women can only be achieved if the social dimensions of health are fully taken into account.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101032"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143099352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Envelope culture in the healthcare system: Happy poison for the vulnerable","authors":"Q.-H. Vuong ,&nbsp;V.-P. La ,&nbsp;G. Hoang ,&nbsp;T.-T. Vuong ,&nbsp;M.-H. Nguyen","doi":"10.1016/j.jemep.2025.101080","DOIUrl":"10.1016/j.jemep.2025.101080","url":null,"abstract":"<div><h3>Background</h3><div>Bribing doctors for preferential treatment is rampant in the Vietnamese healthcare system, which is commonly deemed an “envelope culture.” This study employed the mindsponge theory for reasoning the mental processes of both patients and doctors for why they embrace the “envelope culture”.</div></div><div><h3>Methods</h3><div>The Bayesian Mindsponge Framework (BMF) analytics was employed on a dataset of 1042 Vietnamese patients to validate our reasoning.</div></div><div><h3>Results</h3><div>The study discovered that bribing doctors can help patients reduce the destitution risk induced by treatment. Such effect of doctor bribery remains consistent among patients who pay high daily costs (e.g., accommodation and subsistence fees) regardless of their employment status. Nevertheless, for patients with no or unstable jobs, their risks of destitution increase if they have to pay more thank-you money.</div></div><div><h3>Conclusion</h3><div>These findings suggest that doctor bribery is an adaptive strategy for patients in an environment where the healthcare supply cannot meet the actual demand. Moreover, healthcare equity is greatly exacerbated, as vulnerable individuals are exposed to a greater threat of poverty.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101080"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697330","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 Impact of Patient Characteristics on Total Hospital Cost in Patients Undergoing Coronary Artery Bypass Grafting","authors":"J. Katsiroubas ,&nbsp;J. Wong ,&nbsp;K. Jonnalagadda ,&nbsp;T.S. Guy","doi":"10.1016/j.jemep.2025.101072","DOIUrl":"10.1016/j.jemep.2025.101072","url":null,"abstract":"<div><h3>Introduction</h3><div>Coronary artery bypass graft (CABG) is one of the most common surgeries in the United States, with an average cost around $40,000. However, the burden of these costs may fall unequally among patients of different demographic groups. The objective of this study is to characterize factors associated with increased total cost after coronary artery bypass graft surgery.</div></div><div><h3>Methods</h3><div>The Statewide Planning and Research Cooperative System (SPARCS) database for years 2017–2021 was queried to identify patients who had undergone CABG in New York State. Patient characteristics including gender, age, race, and All Patient Refined (APR) severity of illness (SOI), and risk of mortality (ROM) were analyzed. The Primary outcome was total cost. Data was analyzed using Student t-test and univariate analysis.</div></div><div><h3>Results</h3><div>Between 2017 and 2021, 38,344 patients, 76.6% male, underwent CABG in New York State. Race was documented identifying 67.0% White, 7.0% Black/African American, 0.7% multiracial, and 25.4% other. The mean length of stay (LOS) was 9.9 days. The average total hospital cost was $61,596.90. The average hospital cost for Black/African Americans was $71,683.12, 19.7% ($14,119.67) more than Whites, the lowest paying racial group (13.56 <em>P</em> &lt; 0.05). Black/African Americans also had the longest average LOS of 11.7 days, compared to 9.6 days for white patients, 11.3 days for multi-racial patients and 10.3 days for those who identified as other. Univariate analysis exhibited factors associated with the top quartile of hospital cost (≥$68,608) for CABG included Black/ African American race (2.01 CI 0.61−0.78), LOS more than 6 days (9.68, CI 2.18–2.35), major APR severity of illness (5.55, CI 1.15–1.91) and extreme (28.09, CI 3.13–3.54) and major (5.28, CI 1.56–1.76) and extreme APR risk of mortality (16.9, CI 2.72–2.94).</div></div><div><h3>Conclusion</h3><div>The cost of coronary artery bypass grafting surgery is influenced by a variety of factors including race, APR severity score, mortality risk and length of stay.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101072"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577660","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 US healthcare system facilitates medical conspiracy theories: A call to action","authors":"C. Bobier,&nbsp;J. Obeid","doi":"10.1016/j.jemep.2025.101090","DOIUrl":"10.1016/j.jemep.2025.101090","url":null,"abstract":"<div><div>Medical conspiracy theories pose a public health risk and erode trust in healthcare providers. While research continues on the psychological, social, and evolutionary foundations of conspiratorial thinking, as well as on intervention strategies, less attention has been given to the role of healthcare system structures. This paper examines how the design and delivery of the U.S. healthcare system contribute to the spread of medical conspiracy theories. Using a two-pronged analytical framework, we (1) identify key features of the U.S. healthcare system and patient experience and (2) map these features onto known psychological and social drivers of conspiratorial beliefs. We argue that addressing medical conspiracy theories requires not only individual or community-level interventions but also structural reforms in healthcare. Researchers should therefore explore the feasibility and impact of systematic changes in mitigating conspiratorial thinking.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101090"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143776544","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":"Shifting landscapes: Post-COVID-19 infectious disease focus in Vietnam","authors":"N.X. Ha ,&nbsp;A.M. Nguyen ,&nbsp;R. Elsheikh ,&nbsp;A.M. Makram ,&nbsp;N.T. Huy","doi":"10.1016/j.jemep.2025.101083","DOIUrl":"10.1016/j.jemep.2025.101083","url":null,"abstract":"","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101083"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143760116","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":"Emerging infectious threats: first identification of reovirus cases in Bangladesh","authors":"S. Jamil ,&nbsp;S. Biswas ,&nbsp;N. Ali ,&nbsp;F. Ahmed","doi":"10.1016/j.jemep.2025.101050","DOIUrl":"10.1016/j.jemep.2025.101050","url":null,"abstract":"","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101050"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429537","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":"Bioethical challenges and artificial intelligence, focus Quebec/France","authors":"O. Gout ,&nbsp;M. Lacroix","doi":"10.1016/j.jemep.2025.101058","DOIUrl":"10.1016/j.jemep.2025.101058","url":null,"abstract":"<div><div>The authors discuss the potential benefits of AI for the healthcare system. To do this, they consider the importance of ensuring the confidentiality of medical data, maintaining a patient-doctor relationship imbued with humanity, as well as liability remedies specific to stemming the potential abuses of AI.</div></div><div><h3>Context</h3><div>In the healthcare sector, both in France and in Canada, AI is expected to be a tool for transforming and democratising healthcare by improving its quality, safety and effectiveness. We therefore need to analyse the legal framework in place to ensure that these objectives are met.</div></div><div><h3>Methodology</h3><div>The question is addressed on the basis of a study of the rules through the diversity of their conception, their implementation by the courts (case law) and their analysis by the authors making up the doctrine.</div></div><div><h3>Results/discussion</h3><div>The authors discuss the potential benefits of AI for the healthcare system. To do this, they consider the importance of ensuring the confidentiality of medical data, maintaining a patient-doctor relationship imbued with humanity, as well as liability remedies specific to stemming the potential abuses of AI.</div></div><div><h3>Conclusion/outlook</h3><div>While the regulations applicable to AI are considered to be relevant and appropriate for taking account of the various issues, particularly in terms of privacy and liability, it will be necessary to remain attentive to their implementation in order to ensure that the objectives are effectively achieved.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101058"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143213226","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}