Developing World Bioethics最新文献

This paper presents a moral-theoretical evaluation of medical electives, applying different frameworks of distributive justice to the phenomenon of healthcare students visiting countries with less access to resources in order to bolster their own learning. Currently, discussions of ethical issues around these medical electives largely focuses on issues arising during the placement experience itself, in the form of dilemmas to which an individual must react in an ethical way. Applying different frameworks of distributive justice to the wider issue of how an elective project is designed and organised suggests that electives need to focus a great deal more on conferring benefits to host communities - that is, the communities being visited by students from wealthier settings - than is currently the case. To avoid the charge that medical electives are impermissibly extractive insofar as they impose burdens on host communities that are not justified by appeal to the benefits that the visiting students (or their communities) enjoy, I propose that both students and educators in the healthcare professions consider advocating an offsetting system to compensate host communities for the harms caused by the elective's taking place. The offsetting could comprise a monetary payment, a resolution to work in a lower-resource setting in the future, or some combination of those two things. While this system may not even be permissible under all the distributive justice frameworks considered, it represents an improvement on the current state of affairs whilst still allowing trainees to gain useful experiences from electives.

Research integrity has become a pressing concern in China, which accounts for a large share of global retractions. Yet little is known about how research integrity is understood and enacted within teaching hospitals. In this cross-sectional study, we surveyed 106 medical researchers across four Shanghai hospitals to assess their awareness, attitudes, and practices regarding scientific misconduct, as well as the role of integrity education. Most respondents reported familiarity with definitions of fabrication, falsification, and plagiarism and expressed strong disapproval of these behaviors. Nonetheless, 11%-22% indicated some degree of tolerance toward selective reporting or unjustified authorship, and firsthand reports of witnessed misconduct were uncommon. Participation in formal courses or lectures on research integrity was associated with higher knowledge scores and stronger agreement with ethical principles. These findings reveal a tension between high awareness and partial tolerance, highlighting the importance of exploring how institutional cultures and incentive systems may influence ethical behavior in future research and policy efforts.

This paper explores the role of bioethics in addressing the specific challenges faced by LGBTQI+ victims in Colombia's transitional justice process. It argues that queer and feminist bioethics offer both theoretical and practical contributions to the core aims of truth, reparation, and non-repetition by critically engaging with the biomedical discourses at the base of prejudice-based violence. The pathologization of sexual and gender diversity is examined as a structural condition of victimization and re-victimization during and after the armed conflict. Drawing on reports, testimonies, and conceptual frameworks, the paper reflects on how bioethical perspectives can support recognition, dignity, and structural transformation. Rather than advancing prescriptive solutions, the analysis emphasizes the need for ongoing critical engagement with the medical, legal, and social imaginaries that sustain inequality. The article positions bioethics as a field capable of contributing to transitional justice by fostering reflection on difference, responsibility, and the epistemic dimensions of reparation.

Community Advisory Boards (CABs), as a form of community engagement, provide an important mechanism to ensure that research aligns with community needs and priorities by representing broader community interests and guiding research accordingly. Tuberculosis (TB) and multidrug-resistant tuberculosis (MDR-TB) remain significant public health concerns, particularly due to resistance to key first-line anti-TB medications, and individuals affected by these conditions often face stigma and discrimination that hinder timely diagnosis and treatment adherence. Addressing these challenges requires community-driven strategies and improved access to health services, with CABs serving a central role in bridging gaps between researchers, healthcare providers, and affected communities. This study explored the contributions of CAB members in supporting TB/MDR-TB clinical trials, the challenges experienced by trial participants, and the strategies employed to address these challenges. Using an exploratory qualitative design, in-depth interviews were conducted with 17 stakeholders involved in TB/MDR-TB clinical trials, and data were analyzed using deductive thematic analysis. The findings highlight persistent stigma and discrimination, limited understanding of the role and functions of CABs, inconsistent budget allocation, reduced participation, and diminished CAB influence throughout the research process. The study underscores the essential role of CABs in enhancing community engagement in TB/MDR-TB clinical trials and emphasizes the need for greater awareness, advocacy, and institutional support to strengthen their contributions. Adequate and sustained funding, along with systematic planning and implementation, is critical for reinforcing CAB roles and promoting more ethical, inclusive, and responsive public health research practices in Ethiopia and other low- and middle-income countries.

Lack of transparency in healthcare systems is a critical challenge that undermines accountability, fuels corruption, and erodes public trust. While transparency has been shown to generate multiple positive outcomes, the Iranian healthcare system continues to suffer from significant deficits in this area. To investigate this issue, a qualitative approach was employed, which involved conducting 35 in-depth interviews with experts and social activists engaged in healthcare system transparency at all levels, recruited through purposive stratified sampling method. This was followed by a thematic analysis aimed at exploring the causes and consequences of the phenomenon. The results indicated that the causes of the lack of transparency in the Iranian healthcare system can be categorized into four main domains: sociopolitical, psychological and behavioral, organizational, and ethical and legal factors. Additionally, the consequences of the lack of transparency can be classified into three primary categories: ethical, organizational, and social factors. The findings of this study provide needed data to enhance transparency and cultivate a culture of openness and accountability in the Iranian healthcare system and other similar contexts.