Ethics, Medicine and Public Health最新文献

{"title":"How vaccine-derived poliovirus has questioned the public health response to emerging infectious diseases","authors":"A. Zarzeczny,&nbsp;P. Kahar,&nbsp;V. Weiss","doi":"10.1016/j.jemep.2025.101152","DOIUrl":"10.1016/j.jemep.2025.101152","url":null,"abstract":"<div><h3>Background</h3><div>This review aims to explore the existence of poliovirus from the peak of epidemics to modern resurgences, understand its public health response in polio-endemic countries, and the influence of public perceptions of vaccine-derived polio on its eradication progress.</div></div><div><h3>Methodology</h3><div>A literature search was conducted using combinations of the search terms polio, eradication, vaccine-derived, global, resurgence, Covid-19, and vaccination. A total of 15 articles were included in the review.</div></div><div><h3>Discussion</h3><div>Polio has become overshadowed by recent health issues dominating the interest of public health agencies and the World Health Organization. Endemic countries struggle to eradicate polio as civil conflict, foreign distrust, and public health misinformation have produced a lack of political will to eradicate polio. Furthermore, the militarization of public health has caused eradication initiatives to lose their credibility and has painted humanitarian aid as an ulterior motive. Additionally, countries that are struggling to contain polio are suffering from resource shortages and new health issues prompted by the Covid-19 pandemic. As millions of immunizations were missed during the pandemic, there has been concern for a global uprising of polio following surges of polio cases in both endemic and polio-free countries. Although eradication programs in the past have emphasized the need for programs tailored to communities’ needs and a strong sense of global collaboration, this strategy has been poorly utilized by recent polio programs.</div></div><div><h3>Conclusion</h3><div>Efforts to eliminate polio go beyond acquiring the tools for eradication. Although effective interventions and screening procedures for polio exist, eradication cannot be achieved unless barriers to accessibility and poor political will are addressed. Given this, polio resurgences demand a change in the way polio is perceived by the public as well as a unified global commitment to eradicate polio.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101152"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513572","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":"Overcoming language barriers in pediatric clinical research: A qualitative study of researchers' views","authors":"S. Chhina ,&nbsp;S. Moreheart ,&nbsp;J. Claydon ,&nbsp;B. Udall ,&nbsp;M. Sadarangani ,&nbsp;H. Longstaff ,&nbsp;A. Orth ,&nbsp;Q. Doan","doi":"10.1016/j.jemep.2025.101171","DOIUrl":"10.1016/j.jemep.2025.101171","url":null,"abstract":"<div><h3>Background</h3><div>Limited English proficiency (LEP) can act as a barrier to equitable access to pediatric clinical research participation. This study examined researchers' perspectives on challenges and opportunities for including patients and families with LEP.</div></div><div><h3>Methods</h3><div>Semi-structured interviews were conducted with 26 researchers and hospital leaders at two hospitals in British Columbia, Canada. Interviews explored experiences offering research opportunities to populations with LEP and perceived barriers and facilitators. Thematic analysis was used to analyze interview transcripts.</div></div><div><h3>Results</h3><div>Five themes emerged: 1) lack of translation/interpretation resources; 2) unclear best practices; 3) doubts about translation quality; 4) low prioritization; 5) facilitators. Barriers existed at institutional and individual levels.</div></div><div><h3>Conclusion</h3><div>A comprehensive approach is needed to support equitable participation of patients with LEP in pediatric health research, including increased funding, cultural competence training, community partnerships, and language-inclusive design. Recognizing and addressing multi-level barriers can promote fully representative and equitable research participation for populations with LEP.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101171"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144903860","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":"Bridging worlds: A case-series on cultural challenges for second-generation oncological adolescents with palliative care needs","authors":"A. Santini ,&nbsp;A. Mercante ,&nbsp;A. Marinetto ,&nbsp;F. Benini","doi":"10.1016/j.jemep.2025.101177","DOIUrl":"10.1016/j.jemep.2025.101177","url":null,"abstract":"<div><div>The role of the child and family’s cultural dimension in influencing healthcare experiences and outcomes has been increasingly recognized in pediatric palliative care (PPC). Therefore, a culturally sensitive project of care is essential to allow the person-centered, holistic, and tailored approach that characterizes PPC. However, this is not always easy.</div><div>Second-generation immigrants have a unique social and cultural background and may face numerous challenges in balancing their bicultural identity. This report explores the complexities associated with shared decision-making and individual care planning within the realm of PPC across diverse cultural contexts. It employs an illustrative case series to emphasize the need to build bridges between different cultures within which the young person lives and finds balance.</div><div>Serving as intermediaries for their families, they often endure uncomfortable and demanding roles, which results in a diminished awareness of their personal needs and concerns. Clinicians generally find it more effective to engage directly with the adolescent rather than with their parents, often presuming that the parents share values and beliefs similar to those of their child. However, such assumptions may overlook significant cultural and generational disparities.</div><div>Delivering comprehensive support to adolescents within these dynamics is imperative, as it assists them in managing their intricate roles and navigating cultural disparities. Concurrently, enhancing clinicians’ awareness of these dynamics is vital for promoting a more culturally competent approach to care. This discourse emphazises strategies for effective communication and bridging cultural differences, outlining implications for practice and policy in multicultural environments.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101177"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144903861","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 ethics of exposure: Relational bioethics, responsibility, and systemic failure in psychiatry and mental healthcare","authors":"P. Scognamiglio ,&nbsp;D. Morena","doi":"10.1016/j.jemep.2025.101189","DOIUrl":"10.1016/j.jemep.2025.101189","url":null,"abstract":"<div><h3>Background</h3><div>This study examines the ethical, institutional, and legal factors influencing psychiatric care in Italy, highlighting how systemic fragmentation, chronic underfunding, and increasing medico-legal liability contribute to moral distress among clinicians and the adoption of defensive psychiatric practices. The objective is to assess the impact of these factors on both patient outcomes and the capacity of healthcare professionals to deliver effective and ethically sound care.</div></div><div><h3>Methodology</h3><div>Using a qualitative, narrative-based, and reflexive methodology, the paper draws on the testimonies of the authors and a series of anonymized clinical narratives, including but not limited to cases of suicide. These accounts were selected for their paradigmatic value in revealing structural dynamics, rather than for statistical representativeness. The analysis combines narrative ethics and relational bioethics to examine how systemic vulnerability manifests in everyday psychiatric practice.</div></div><div><h3>Discussion</h3><div>Fear of litigation and institutional abandonment can significantly influence clinical judgment, resulting in excessive control measures, procedural overreach, and emotional exhaustion among healthcare professionals. Defensive practices – such as over-hospitalization, over-prescription, and hyper-documentation – arise not from negligence but as adaptive responses to institutional fragility.</div></div><div><h3>Perspectives</h3><div>The study offers three key contributions. First, it recalls the One Health paradigm as the only viable framework for bringing together mental healthcare and institutional ethics, highlighting the need for interdependent and ethically sustainable systems of care. Second, it situates the Italian case within a broader reflection on the erosion of meaning in mental health practice within systems that demand total accountability without offering protection to their professionals. Finally, it calls for institutional architectures capable of sustaining both clinical presence and shared responsibility.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101189"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145026748","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":"Care and support for the elderly in France: Major managerial challenges","authors":"C. Pascal","doi":"10.1016/j.jemep.2025.101161","DOIUrl":"10.1016/j.jemep.2025.101161","url":null,"abstract":"<div><h3>Background</h3><div>France, like many other developed countries, is experiencing a significant demographic transition marked by an ageing population. This shift has resulted in a growing demand for care and support services for older people. In response, the French government has implemented several policy measures, including the promotion of home-based care and the development of coordination support systems, in an effort to maintain autonomy and contain costs.</div></div><div><h3>Objectives</h3><div>This article aims to identify and analyze the main managerial challenges that elderly care institutions and services in France must address to adapt to the changing healthcare and social landscape.</div></div><div><h3>Methods</h3><div>The analysis is based on a selective review of recent French official reports and peer-reviewed scientific publications related to elderly care policies, service organization, and workforce management.</div></div><div><h3>Findings</h3><div>Five major managerial challenges are identified:</div><div>- Strategic human resources management – The sector faces severe workforce shortages, particularly among nurses and care workers, due to low pay, difficult working conditions, and limited career prospects.</div><div>- Operations management and planning – Rising costs associated with increasing care needs, real estate expenses, and regulatory requirements necessitate enhanced efficiency and procurement strategies.</div><div>- Organizational memory – High staff turnover risks eroding institutional know-how and calls for procedural reinforcement to sustain quality and safety in care delivery.</div><div>- Care pathways – While public authorities seek greater coordination and integration of health and social services, operationalising this ambition remains difficult due to institutional fragmentation, ambiguous responsibilities, and a lack of shared tools and data.</div><div>- Transportation and mobility – The limited mobility of frail older adults complicates their access to healthcare and support services. This challenge is exacerbated by rising energy costs and environmental policies aimed at reducing car travel, which constrain traditional models of transportation. While e-health solutions offer promising alternatives to in-person care, their deployment requires a broader reconfiguration of service delivery models and associated economic structures.</div></div><div><h3>Conclusion</h3><div>Elderly care services in France must navigate multiple structural and operational challenges to adapt to demographic and systemic changes. Addressing these issues requires strategic investment in workforce development, service coordination, and innovation in care delivery mechanisms.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101161"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048292","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":"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}