Ethics, Medicine and Public Health最新文献

{"title":"Fundamental principles of French bioethics — Between myth and reality","authors":"C. Byk","doi":"10.1016/j.jemep.2025.101078","DOIUrl":"10.1016/j.jemep.2025.101078","url":null,"abstract":"<div><div>French bioethics is often perceived as an ethic that gives precedence to legislative norms over flexible ethical standards. In our view, the French approach is more nuanced. Although its regulatory force is based essentially on State standards, these combine a series of principles inspired by human rights with provisions specific to each biomedical technique, the latter themselves being influenced by the practices of healthcare professionals. In addition, this legislation has a dual political aim: to ensure that citizens have access to new medical technologies, and to enhance the professional, moral and economic quality of the healthcare system, hence the need for new players (ethics committees and health agencies) to oversee this dynamic. The result is a complex system, with a multiplicity of players whose roles sometimes overlap, leading to a number of phenomena: risks of incoherence and the temptation of a State takeover, further neglecting clinical ethics and citizen participation in the development of public policy.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101078"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704971","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":"“ReArm Europe”: A potential further disarmament of health systems?","authors":"A. Cioffi,&nbsp;C. Cecannecchia","doi":"10.1016/j.jemep.2025.101076","DOIUrl":"10.1016/j.jemep.2025.101076","url":null,"abstract":"","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101076"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143643305","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 art of care: How self-care fuels caring for others. Can care be a public health goal in the context of equity and hospital practices?","authors":"P. Ahtoy","doi":"10.1016/j.jemep.2025.101099","DOIUrl":"10.1016/j.jemep.2025.101099","url":null,"abstract":"<div><div>This article examines the concept of <em>care</em> as a lever to promote equity in public health, with a specific focus on public hospitals as central care providers. It explores how self-care among healthcare professionals directly impacts their ability to deliver compassionate, inclusive, and equitable care to patients. By analyzing innovative hospital practices, field examples, and theoretical perspectives, the article offers actionable recommendations for embedding <em>care</em> principles in public hospitals to enhance equity and public health outcomes. Public hospitals face mounting challenges: job cuts, budgetary constraints, increasing workloads, failing and ageing hospital equipment, health professional mental burdens sometimes leading to burnouts. These issues occur in an environment with growing health disparities, undermining health professionals’ capacity to provide equitable and human-centered care.</div><div>As a researcher, I have found that my personal self-care practices—<em>hygge</em> moments of coziness, beauty rituals, yoga and meditation—significantly enhance my mental and physical well-being. These practices create a foundation that allows me to approach my work with greater patience, empathy and attentiveness, benefiting both my colleagues, students, interviewees and work partners.</div><div>In public hospitals, where time pressures and emotional demands are intense, professionals often neglect self-care. This oversight can lead to burnout, diminished quality of care, and inequities in patient outcomes.</div><div>How can health professionals’ personal self-care practices serve as a model for fostering a culture of <em>care</em> in public hospitals, contributing to equity and better health outcomes?</div><div>Can <em>care</em>, understood as both an attentive practice and an ethical framework, become a key strategy for improving equity and public health in public hospitals?</div><div>Firstly, we shall analyze the links between equity and public health through the lens of <em>care</em>. Then, we shall highlight the importance of health professionals’ well-being in delivering high-quality, equitable care. Finally, we shall propose concrete recommendations for integrating <em>care</em> principles into public hospital policies and practices.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101099"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816067","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":"Medical and museum collaboration for iconodiagnosis in dermatology: the example of the Musée de Fécamp","authors":"B. Hillion ,&nbsp;C. Déchelette ,&nbsp;N. Sébille ,&nbsp;A. Perciaccante ,&nbsp;P. Charlier","doi":"10.1016/j.jemep.2024.101035","DOIUrl":"10.1016/j.jemep.2024.101035","url":null,"abstract":"<div><h3>Introduction</h3><div>A group of international doctors and scientists with a passion for art history has established the International Society of Iconodiagnosis (ISI) to advance research and awareness in iconodiagnosis. ISI initiated the collaborative project \"SKIN &amp; ART,\" focusing on identifying dermatological cases of iconodiagnosis through an unprecedented partnership between the medical and museum communities.</div></div><div><h3>Materials and methods</h3><div>A call for research proposals was published on the international website <em>La Tribune de l’Art</em>. The Musée de Fécamp in France was the first museum to respond, granting access to its permanent collection and to all non-exhibited artworks of the museum’s storages.</div></div><div><h3>Results</h3><div>The collaboration between the medical team, which analyzed visible dermatological lesions, and the museum conservation team, which provided insight into artists, paintings, and local archives, led to the identification of four cases of dermatological iconodiagnosis only in the museum storages: three nevi and one case of seborrheic keratosis.</div></div><div><h3>Conclusion</h3><div>Our goal is to help replicate this type of bilateral collaboration in other international museums to uncover further iconodiagnosis cases and establish an open resource database for researchers, doctors, and art historians.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101035"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143098928","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 fall of Assad: Implications for Syria’s healthcare system","authors":"A.J. Nashwan ,&nbsp;S. Swed","doi":"10.1016/j.jemep.2025.101059","DOIUrl":"10.1016/j.jemep.2025.101059","url":null,"abstract":"","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101059"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143348889","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":"Patient demographics and their impact on discharge patterns following cardiac valve surgery","authors":"J. Katsiroubas ,&nbsp;S. Basharkhah ,&nbsp;S. Balaram","doi":"10.1016/j.jemep.2025.101071","DOIUrl":"10.1016/j.jemep.2025.101071","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this study is to find factors associated with increased length of stay and type of patient disposition after cardiac valve surgery</div></div><div><h3>Methods</h3><div>The Statewide Planning and Research Cooperative System (SPARCS) database for the most recent year available was queried to identify patients who had undergone non-endovascular cardiac valve surgery. Patient demographics including gender, race, and age, were analyzed. Primary outcomes were length of stay and patient disposition.</div></div><div><h3>Results</h3><div>A total of 4,815 patients were queried via the SPACRCS database, all of whom had undergone a non-endovascular heart valve procedure in the year 2021. The majority of these patients, constituting 62.2 percent, were male. Age was categorized into five groups, with the largest proportion, 48.91 percent, falling within the 50–69 age range. Race data indicated that 67.1 percent were White, 9.1 percent were Black/African American, 1.2 percent were multiracial, and 22.7 percent identified as other races. The mean length of stay (LOS) was calculated at 11.4 days. Notably, Black/African American patients had the longest mean LOS at 14.3 days, whereas White patients had an average LOS of 10.2 days, multiracial patients had 11.3 days, and those identifying as other races had 13.7 days. When it came to discharge dispositions, 47.6 percent were sent home with home care. Among these patients, a significant portion, 64.8 percent, were male, and 66.1 percent were White. Conversely, only 3.4 percent of patients were discharged to an inpatient rehabilitation facility, and within this group, 54.4 percent were aged 70 or older. Patients discharged to an inpatient rehabilitation facility averaged a LOS of 22.3 days versus 10.2 days for patients discharged home with home services.</div></div><div><h3>Conclusion</h3><div>A variety of factors influence the discharge pattern of after cardiac valve surgery in New York State. Further research and analysis would be beneficial to understand the underlying factors driving these trends and to improve the quality of care and resource allocation for this patient population.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101071"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577659","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 infernal machine: Demons, trials, and the current state of the judicial rush","authors":"P. Charlier","doi":"10.1016/j.jemep.2025.101077","DOIUrl":"10.1016/j.jemep.2025.101077","url":null,"abstract":"","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101077"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683424","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":"AI in dermatology for low-income countries: addressing challenges and bridging gaps","authors":"Diala Ra’Ed Kamal Kakish ,&nbsp;Jehad Feras AlSamhori ,&nbsp;Abdulqadir J. Nashwan","doi":"10.1016/j.jemep.2025.101049","DOIUrl":"10.1016/j.jemep.2025.101049","url":null,"abstract":"","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101049"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683430","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":"Ethical dilemmas in voluntary termination of pregnancy with severe congenital anomalies","authors":"N.A. Mappaware ,&nbsp;T. Irianta ,&nbsp;M. Avisha","doi":"10.1016/j.jemep.2025.101084","DOIUrl":"10.1016/j.jemep.2025.101084","url":null,"abstract":"<div><h3>Background</h3><div>Congenital anomalies (CA) are structural or functional disorders from genetic defects of the fetus occurring in the uterine. However, screening for congenital disabilities to establish a prenatal diagnosis raises many moral considerations and ethical dilemmas in the field of medicine. A detected severe CA consequence to termination of pregnancy in the management option, making it an undoubtful ethical dilemma.</div></div><div><h3>Methods</h3><div>A literature search was carried out on Indonesian laws, ethical codes, and regulations related to congenital anomalies, utilizing resources such as the Indonesian Medical Association (Ikatan Dokter Indonesia) and the conference proceedings of the Royal College of Obstetricians and Gynecologists (RCOG). An extensive literature search was also utilized from PubMed, Clinical Key, and Elsevier Science journals with specific keywords.</div></div><div><h3>Results</h3><div>Ethical dilemmas often arise in the context of prenatal diagnosis, which involves a complex process across five distinct stages: disclosure of information to parents, establishing indications for examinations, providing information about a diagnosis, providing psychological and social support, and making diagnostic decisions. The framework proposed by Jonsen, Siegler, and Winslade can be applied to ethical decision-making in the present case.</div></div><div><h3>Conclusion</h3><div>The choice to terminate a pregnancy due to genetic anomalies or congenital disabilities must comply with the legal bases. The principles of autonomy of each patient and the results of the doctor's decisions have been carefully considered, and the obstetrician must make every effort to respect and protect the dignity of human life.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101084"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725169","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":"Mirebalais: Last bastion before the total collapse of the Haitian healthcare system","authors":"P. Charlier","doi":"10.1016/j.jemep.2025.101096","DOIUrl":"10.1016/j.jemep.2025.101096","url":null,"abstract":"","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101096"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816158","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}