BMC Medical Ethics最新文献

Introduction: Brazil has one of the largest drug retail markets globally and more than three times the recommended number of pharmacies per inhabitant. In this scenario, pharmacists have ethical dilemmas that lead to poor credibility among the population. Due to the lack of studies that address the view of stakeholders who are essential in delineating the code of conduct in this scenario, they had to be heard so that business imperatives could be better understood. This study aimed to understand the perceptions of drug retail stakeholders regarding the influences, causes, and strategies needed to minimize ethical dilemmas in pharmacy practice.

Methods: Nineteen semi-structured interviews were conducted online, transcribed, and analyzed by content analysis. Word clouds and themes were created, and we compared the opinions reported by the groups of managers and mentors.

Results: The results of the perceptions were classified into the following themes: (a) Industry Enticement-main consequence, (b) "Push therapy" and strategies to minimize these dilemmas, (c) Assimilating that selling is not unethical, (d) Compliance, (e) Collective goals, (f) Generating profits through services. The poor diffusion of compliance programs and the fragile autonomy of the pharmacist keep the profession on the "tightrope". Therefore, investing more in services and state actions for patient safety rather than in products could balance this scenario.

Conclusion: The ethical discourse of stakeholders remains ideological and is not consolidated in pharmacy practice. Accelerating market regulation through compliance and effective state action, as well as monetizing pharmaceutical services, could create a more ethical environment for the sector.

Artificial intelligence (AI) is profoundly transforming the healthcare landscape, presenting unprecedented opportunities to enhance patient care and clinical outcomes. However, the rapid integration of AI technologies has raised significant ethical concerns, requiring rigorous scrutiny to ensure their responsible and equitable use. This study aimed to explore the ethical considerations and strategies related to the implementation of AI in healthcare through a systematic review. A systematic search identified 243 publications published between 2019 and 2025 that were initially identified. After applying inclusion and exclusion criteria, 22 papers were selected for final synthesis to assess ethical concerns and strategies related to AI in healthcare. The analysis identified key ethical concerns, categorizing them into six distinct groups: (1) Transparency and Trust, (2) Bias and Fairness, (3) Privacy and Data Security, (4) Accountability and Responsibility, (5) Ethical and Moral, (6) Regulatory and Legal. Additionally, several ethical strategies were identified in the implementation of AI systems, including adherence to ethical principles, standards, and frameworks; transparency and bias mitigation; monitoring and auditing of AI systems; and stakeholder involvement and governance in decision-making processes. This review emphasizes the importance of addressing these ethical concerns to ensure the successful implementation of AI technologies in healthcare. The findings provide valuable insights and recommendations for stakeholders, including developers, healthcare professionals, and policymakers, to guide the ethical deployment of AI decision support systems in healthcare.

Background: Ethical safeguards are critical in HIV research involving minors, especially vulnerable groups such as men who have sex with men (MSM) under 18 years. This systematic review explores how informed assent and consent practices are reported, guided by the 2016 Council for International Organizations of Medical Sciences (CIOMS) guidelines.

Methods: A systematic review was conducted of peer-reviewed studies from 2010 to 2023 involving MSM under 18 years, using PubMed, Embase, and Scopus databases. Key ethical components were extracted and synthesized thematically.

Results: Of 410 articles screened, 65 met inclusion criteria. All included studies reported informed consent, but only 20% (n = 13) included informed assent. Most were conducted in high-income countries (64%), with no representation from low-income settings. Only 7% involved minors living with HIV. Quantitative methods were predominant (82%), and 20% used online platforms. Waivers of parental permission were reported in 27% of studies, while only 3% obtained parental permission. Four studies described tailored consent/assent approaches, such as simplified language, comprehension checks, and involvement of minor advocates.

Conclusion: This review highlights inconsistencies in how informed assent is addressed in HIV research involving MSM minors. Only one in five studies described ethically appropriate, youth-tailored processes. Limited use of waivers and adapted assent procedures points to ongoing gaps in aligning research with ethical standards. Future studies should adopt clearer, age-appropriate consent practices, ensure transparent reporting, and strengthen researcher training in ethics involving vulnerable minors.

Background: As part of the European Be better informed about Fertility project (B2-InF), we carried out a normative analysis of the information provided online by assisted reproduction clinics to the European public. This analysis aimed to determine the degree to which this information complies with regulations of medically assisted reproduction (MAR) and commercial information, and the main ethical implications related to the duty of information.

Methods: Information was gathered from the websites of 33 clinics across 8 European countries (Albania, Belgium, Spain, Italy, Kosovo, Northern Macedonia, Slovenia, Switzerland). Nearly 2000 pages of information were reviewed and checked for compliance with relevant frameworks of national and international law.

Results: The assessment revealed significant inconsistencies in how clinics present information online, with particular concerns regarding transparency about success rates, associated risks, add-on techniques and the legal and ethical issues that may arise during the use of these techniques.

Conclusions: The results of our analysis indicate an urgent need for enhanced regulatory oversight and standardized information requirements for assisted reproduction clinics across Europe. These findings suggest the necessity for harmonized legal frameworks that mandate comprehensive disclosure standards and establish effective enforcement mechanisms to ensure transparent and accurate information provision to potential patients.

Background: Science and technology drive research progress but also introduce growing risks, value conflicts and ethical challenges. Science and technology ethics review committees (STERCs) serve as key institutional mechanisms to ensure that scientific activities comply with ethical principles and professional norms. However, the establishment of STERCs worldwide remains at an early developmental stage, and structured, systematic criteria for evaluating their quality are largely absent. This study aims to develop a structured evaluation indicator system for STERCs and to explore its preliminary applicability.

Methods: This study conducted a literature review and qualitative interviews to develop a preliminary evaluation indicator system, which was organized using Donabedian's three-dimensional framework of structure, process, and outcome. The final indicator system was established after two rounds of expert consultation. The preliminary self-assessment data were collected from 80 medical institutions and 19 companies across 14 cities in Hunan Province.

Results: Both rounds of the Delphi consultation achieved a 100% response rate. The mean authoritative coefficient (Cr) was 0.900, while familiarity (Cs) and judgment basis (Ca) scores were 0.867 and 0.933, respectively. Kendall's coefficient of concordance (Kendall's W) was 0.300 (p < 0.001) in round one and 0.213 (p < 0.001) in round two. The final evaluation indicator system consisted of three first-level indicators, nine second-level indicators and 52 third-level indicators.

Conclusions: This study proposes a unified framework for science and technology ethics review, integrating activities involving humans, animals, and other potential technological risks into a single evaluation system. The indicator system supports institutional self-assessment, promotes standardization, and guides continuous improvement. Preliminary findings indicate its feasibility and internal consistency, but these results should be interpreted cautiously due to the limited sample scope and reliance on self-reported data.