Developing World Bioethics最新文献

Current policies in mainland China strictly distinguish between social egg or embryo freezing and medical egg or embryo freezing. Single women are not allowed to undergo social egg freezing, and even married couples are prohibited from social embryo freezing. This paper argues, from the perspective of Confucian virtue ethics, which is still the most influential traditional ethical framework in contemporary Chinese society, that prohibiting married couples from social embryo freezing cannot be justified. It also refutes the arguments supporting this ban point by point, showing that they are morally unfounded. The paper concludes that the ban should be lifted. This is not intended to encourage married couples to freeze embryos or to consider social embryo freezing an ideal reproductive choice according to Confucian ethics. Rather, it aims to highlight an important Confucian ethical point: just because social embryo freezing is not an ideal reproductive choice, it does not necessarily justify prohibition by state power.

This article explores the ethical and legal challenges of death by neurological criteria (DNC) in a 20-week pregnant patient, focusing on the tension between patient autonomy and fetal well-being. Through an educational clinical case, it analyzes the clinical, bioethical, and legal aspects, considering advance directives, family expectations, and biomedical possibilities. The case raises ethical concerns about the instrumentalization of the woman's body when prolonging life support during pregnancy. The analysis emphasizes the importance of respecting the patient's autonomy and ensuring posthumous dignity. It also highlights the role of interdisciplinary teams in balancing clinical, ethical, and emotional factors in decision-making. The discussion underscores principles such as autonomy, best interests, and proportionality, promoting ethical management aligned with individual values. Finally, it offers practical tools for healthcare professionals facing similar situations, fostering comprehensive family support and informed bioethical deliberation.

Mpox, first identified in captive monkeys in 1958 and recognized in humans by 1970 in the Democratic Republic of Congo, was historically confined to sporadic zoonotic outbreaks in Central and West Africa. These outbreaks, often driven by rodent-to-human transmission in resource-limited settings, reflect persistent systemic health disparities. In recent years, mpox has also been reported in high-income countries (including the United States, United Kingdom and Europe), underscoring its global health implications beyond traditionally endemic regions. This article examines the mpox outbreak through the lens of public health ethics, evaluating how core ethical frameworks-justice (encompassing equitable vaccine distribution and addressing health inequities), solidarity and respect for rights (including intellectual property considerations)-shape outbreak management strategies. These strategies are ensuring equitable access to vaccines and therapeutics amid intellectual property barriers, combating stigma and misinformation through transparent risk communication and fostering international solidarity in coordinating responses. The analysis highlights how neglect of these principles exacerbates existing disparities and undermines the effectiveness of interventions. Integrating ethical principles into outbreak responses is critical for building public trust, accountability and community resilience. By distilling lessons from the mpox response, this article contributes to ongoing debates in public health ethics and outbreak preparedness, arguing that ethically grounded approaches are essential for fair and effective management of future public health crises.

Based on 24 semi-structured interviews with secondary hospital doctors, we empirically investigate how a new two-way referral system in China influences the alignment between referring doctors, patients, and doctors who receive referrals. In particular, we focus on how this system addresses the challenges of trust, autonomy, and bioethics during the shared decision-making process. Our research shows that the two-way referral system has spawned new acquaintance networks, therefore improving communication and collaboration between doctors. Especially during upward referrals, benefits associated with care continuity have been made possible. However, doctors still tend to adopt defensive patient-centered strategies in referral communication. They consult patients' desires and play an information provider role. This is influenced by both procedural requirements imposed by managerial rules and uncertainty caused by medical consumerism. Thus, we argue that the Chinese bioethical issue of doctor-patient relationships has gradually turned to a mismatch of concerns between doctors and patients.

Anaesthesia waste gases (AWGs) represent a significant yet often overlooked contributor to healthcare's environmental footprint, with implications extending beyond ecological concerns to encompass occupational hazards and complex ethical considerations. This article examines the intersection of AWGs and bioethics through the framework of environmental stewardship, occupational health principles, patient-centered care, and distributive justice. Contemporary volatile anaesthetics possess global warming potentials thousands of times greater than carbon dioxide, while implicated occupational exposures raise concerns about reproductive health and neurological function among healthcare workers. The bioethical paradigms of principalism-encompassing nonmaleficence, beneficence, autonomy, and justice-and environmental ethics provide structured approaches to addressing these multifaceted challenges. This review synthesizes current evidence regarding AWGs' environmental and occupational impacts, evaluates emerging mitigation strategies, and proposes an integrated ethical framework to guide clinical practice, institutional policy, and professional standards in anaesthesiology.

The concept of brain death as death remains contentious in many societies, particularly in India, where cultural, religious, and social factors significantly influence end-of-life decisions. This article examines the ethical complexities surrounding brain death determination and organ donation in the Indian context, focusing on three critical areas: diagnostic dilemmas in brain death declaration, conflicts between familial beliefs and medical protocols, and emerging ethical concerns in donation after circulatory death (DCD). Despite legislative frameworks like the Transplantation of Human Organs Act (THOA), significant challenges persist in reconciling traditional Indian perspectives on death with contemporary biomedical definitions. The paper analyzes how cultural perceptions of bodily integrity, religious beliefs about the soul's departure, and family-centered decision-making create unique ethical tensions in the Indian organ donation landscape. We argue that an ethically sound approach to organ donation in India requires culturally sensitive protocols, improved communication frameworks, enhanced medical education, and public awareness initiatives that respect pluralistic perspectives while advancing life-saving transplantation practices.

This paper examines the ethical dilemmas surrounding futile care in Indian intensive care units, specifically focusing on the moral distress experienced by healthcare professionals when administering potentially non-beneficial interventions to terminally ill patients. Through analysis of recent literature, including systematic reviews and randomized controlled trials, this commentary explores the complex intersection of medical ethics, cultural values, resource allocation, and decision-making frameworks within India's unique healthcare landscape. The paper highlights the need for culturally sensitive approaches to end-of-life care, improved communication between healthcare providers and families, and institutional support systems to address moral distress among ICU staff. Additionally, it proposes policy recommendations and practical strategies to navigate these challenging ethical terrain while respecting patient dignity, family autonomy, and professional integrity in the Indian healthcare system.

During the COVID-19 pandemic, numerous models were offered for how scarce vaccine resources should be distributed. Proposed vaccine distribution models generally were divided between nationalist models, which give preference to nationals, and cosmopolitan models, which ignore national boundaries. More defensible international vaccine distribution program proposals incorporate ethical considerations from both cosmopolitanism and nationalist models. To date, however, proposed models have insufficiently considered how global interdependence has resulted in economic and ecological harms by high-income countries (HICs) against low-to-middle income countries (LMICs). Because these harms create health burdens for the populations of LMICs, compensatory justice should impact distribution determinations. This paper argues that adequately factoring in global interdependence, compensatory justice, as well as the disproportionate impact of pandemics on LMICs, just vaccine distribution may require prioritizing LMIC populations over those of HICs.