Ethics, Medicine and Public Health最新文献_第2页

Envelope culture in the healthcare system: Happy poison for the vulnerable

Ethics, Medicine and Public Health Pub Date : 2025-01-01 DOI: 10.1016/j.jemep.2025.101080

Q.-H. Vuong , V.-P. La , G. Hoang , T.-T. Vuong , M.-H. Nguyen

{"title":"Envelope culture in the healthcare system: Happy poison for the vulnerable","authors":"Q.-H. Vuong , V.-P. La , G. Hoang , T.-T. Vuong , 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}

引用次数: 0

Shifting landscapes: Post-COVID-19 infectious disease focus in Vietnam

Ethics, Medicine and Public Health Pub Date : 2025-01-01 DOI: 10.1016/j.jemep.2025.101083

N.X. Ha , A.M. Nguyen , R. Elsheikh , A.M. Makram , N.T. Huy

引用次数: 0

Protection of the elderly patient and preservation of decision-making autonomy at the end of life in Belgian law

Ethics, Medicine and Public Health Pub Date : 2025-01-01 DOI: 10.1016/j.jemep.2025.101046

G. Genicot

{"title":"Protection of the elderly patient and preservation of decision-making autonomy at the end of life in Belgian law","authors":"G. Genicot","doi":"10.1016/j.jemep.2025.101046","DOIUrl":"10.1016/j.jemep.2025.101046","url":null,"abstract":"<div><h3>Context</h3><div>In Belgian law, medical decisions are placed under the banner of the patient's <em>self-determination</em>, expressed, if necessary, in the form of <em>binding</em> advance directives or conveyed by a representative – freely chosen, or designated by the law or the judge – who has <em>decision-making powers</em>.</div></div><div><h3>Methodology</h3><div>The way in which the law understands reality differs from that of other disciplines, including the humanities and social sciences. For this subject, reality is studied through the development of rules (issues, content, spirit), but also through their practical application, especially in the case of litigation, through the study of court decisions that may be handed down. This method is used here in relation to end of life.</div></div><div><h3>Results/discussion</h3><div>The patient's decision-making autonomy is the cornerstone of Belgian medical law, and it remains – simply exercised in a different way – when patients are no longer able to exercise their rights themselves. Belgian law provides for (i) an absolute right of an adult patient to refuse any treatment, including in the form of advance directives; (ii) the right to appoint a health proxy whose decision will be binding both on (other) family members and on the doctor; (iii) and, failing that, a \"cascade\" mechanism designating <em>in any event</em> a person empowered to exercise the rights of a patient who is incapable of doing so, and giving the immediate family a decision-making role rather than a merely advisory one, with a hierarchy among family members (priority being given to the spouse, whether married or not).</div></div><div><h3>Conclusion/outlook</h3><div>In medical matters, and especially at the end of life, the crucial point which is illustrated by the legal framework is probably <em>the decision-making model itself</em>. The law should suggest a model which, in this field, is as much societal (and ethical) as strictly legal. In this respect, the scheme set up in Belgian law has the salutary effect to adequately meet the needs of healthcare practice, and the legitimate aspirations of citizens. By placing the centre of gravity of medical decisions on the side of the <em>patient</em> and not the doctor, including at the end of life, it is fundamentally different from a <em>consultation scheme</em>, which results in a decision that is certainly concerted, but remains medical.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101046"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143099345","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}

引用次数: 0

Concerns regarding patient’s safety and oral health risks associated with counterfeit dental materials

Ethics, Medicine and Public Health Pub Date : 2025-01-01 DOI: 10.1016/j.jemep.2024.101038

Shalini Kushwaha , Pooja Puri , Kavita Goyal , Christine Jeyaseelan

引用次数: 0

Health equity checklist for research

Ethics, Medicine and Public Health Pub Date : 2025-01-01 DOI: 10.1016/j.jemep.2025.101064

Nipher Malika , Stacie Salsbury , Ian Coulter , Kieran Cooley , Margaret Chesney , Marcia Prenguber , Kim Tippens , Michele Maiers

{"title":"Health equity checklist for research","authors":"Nipher Malika , Stacie Salsbury , Ian Coulter , Kieran Cooley , Margaret Chesney , Marcia Prenguber , Kim Tippens , Michele Maiers","doi":"10.1016/j.jemep.2025.101064","DOIUrl":"10.1016/j.jemep.2025.101064","url":null,"abstract":"<div><div>Health equity is the principle of ensuring that all individuals have optimal opportunities to attain the best health possible, addressing disparities in access, outcomes, costs, quality, and appropriateness of care. This focus on health equity is important in healthcare research, driven by the need to investigate systemic injustices and foster fair health outcomes for all, regardless of background or circumstances. Researchers have an ethical imperative to focus on issues relevant to populations bearing the highest burdens of illness and inequities. To address the gap in structured guidance for incorporating health equity principles in health-related research, this study aims to introduce a comprehensive health equity checklist developed by the RAND Research Across Complementary and Integrative Health Institutions (REACH) Center. The checklist is designed to ensure that every stage of the research process integrates health equity considerations. RAND, in collaboration with complementary and integrative health academic institutions across the United States, Canada and Puerto Rico, developed a health equity checklist. They combed through literature to assess existing guidance and developed the checklist based on gaps in literature and the specific needs identified through consultations with community partners and stakeholders. This checklist emphasizes creating a health equity research culture, involving community partners, designing inclusive research/interventions, securing equitable funding, and engaging diverse participants. It also advocates for equitable intervention delivery, data collection, analysis, and effective dissemination and sustainability of research findings. The health equity checklist provides a practical guide for researchers, community partners, and participants to reflect on inclusivity, cultural relevance, and social justice in health research. By implementing this checklist, researchers can ensure that their studies are both inclusive and impactful in advancing health equity across all areas of health-related research. Achieving health equity in research requires a comprehensive approach and significant investment in building sustainable partnerships. The RAND REACH Center's recommendations provide a guide to ensure research advances scientific understanding while actively contributing to health equity. This paradigm shift necessitates support from funding agencies and a long-term commitment to creating equitable health outcomes.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101064"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429536","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}

引用次数: 0

Uncertain future: How the USAID freeze endangers global health

Ethics, Medicine and Public Health Pub Date : 2025-01-01 DOI: 10.1016/j.jemep.2025.101067

S.G. Bashir, Y.H. Abdi, Y.B. Abdullahi, M.S. Abdi

引用次数: 0

Bioprecariousness and vulnerability: An ethical approach to the issues of access to public health

Ethics, Medicine and Public Health Pub Date : 2025-01-01 DOI: 10.1016/j.jemep.2025.101066

S. Jimeno Ramírez

{"title":"Bioprecariousness and vulnerability: An ethical approach to the issues of access to public health","authors":"S. Jimeno Ramírez","doi":"10.1016/j.jemep.2025.101066","DOIUrl":"10.1016/j.jemep.2025.101066","url":null,"abstract":"<div><h3>Introduction</h3><div>During the Covid-19 pandemics, the access to patented products (vaccines) become a problem of public health due to their high prices, especially in the least developed countries. Buth the concept of access is also related to other health care-related issues.</div></div><div><h3>Objective</h3><div>This paper seeks to analyse these problems of access in public health by using the notion of bioprecariousness, that we generally define as the structural violence against life due to the lack of access to essential resources for life.</div></div><div><h3>Methodology</h3><div>We shall analyse bioprecariousness by means of literature concerned to the concept of vulnerability, health disparities and IP legislation and shall assess the negative impact of bioprecariousness on global health equity.</div></div><div><h3>Findings</h3><div>We shall present a taxonomy of bioprecariousness considering three different dimensions of health care in form of pharmacological, digital, and care-related bioprecariousness. From that point, we will explore the effects of each kind of bioprecariousness on public health, given that it increases vulnerability and health inequities simultaneously.</div></div><div><h3>Conclusion</h3><div>Bioprecariousness is a concept closely related to vulnerability, which results in important health disparities and unjust distribution of health-related resources, thereby increasing health inequities. We propose to address the issues related to bioprecariousness by applying adequate government policies.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101066"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143454754","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}

引用次数: 0

Mysterious illness outbreaks in the Democratic Republic of Congo: A multidimensional public health emergency

Ethics, Medicine and Public Health Pub Date : 2025-01-01 DOI: 10.1016/j.jemep.2025.101069

M.M. Hassan , I.I. Okon , O.J. Okesanya , M.M. Ahmed

引用次数: 0

Artificial reproductive technologies (ART), a reproductive physician’s standpoint

Ethics, Medicine and Public Health Pub Date : 2025-01-01 DOI: 10.1016/j.jemep.2025.101062

J-F. Guérin

{"title":"Artificial reproductive technologies (ART), a reproductive physician’s standpoint","authors":"J-F. Guérin","doi":"10.1016/j.jemep.2025.101062","DOIUrl":"10.1016/j.jemep.2025.101062","url":null,"abstract":"<div><div>History.- Inseminations with donor sperm have represented the first medically assisted reproduction (MAR) technique. In France, sperm banks gathered rapidly and constituted the “Federation of CECOS”. Three fundamental principles were defined relating to sperm donation: volunteering, gratuity, and anonymity. The rapid development of in vitro fertilization and embryo cryopreservation encouraged the French government to publish in 1994 the first bioethical law, that was supposed to be revised every 5 years.</div><div>New modalities of MAR introduced by the law of 2 August 2021.- MAR that were initially reserved to heterosexual couples, are now open to female couples and unmarried women, thus clarifying a situation that already existed in practice. Literature indicates that there are no major difficulties in children raised by female couples, however there are more concerns about single women. From a practical point of view, this extension of MAR leads to a significant influx of requests, with longer waiting times. Lifting the anonymity of gamete donation raises some problems as destruction of old sperm straws and possible solicitation of former donors who wanted to remain anonymous. Finally, from a medical standpoint, it must be stressed that self-preservation of oocytes will not constitute a guarantee for women to have a child later.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101062"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143348888","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}

引用次数: 0

The hMPV infection in Asia: a call to action in LMICs

Ethics, Medicine and Public Health Pub Date : 2025-01-01 DOI: 10.1016/j.jemep.2025.101052

Z.K. Othman, S.S. Musa, M.M. Ahmed, O.A. Saeed Alhammadi, O.J. Okesanya, A.M. Ibrahim, Don E. Lucero-Prisno III

引用次数: 0