Lawrence O Gostin, Alexandra Finch, Benjamin Mason Meier
{"title":"US Global Health Leadership: The First Year of the Second Trump Administration.","authors":"Lawrence O Gostin, Alexandra Finch, Benjamin Mason Meier","doi":"10.1017/jme.2025.10223","DOIUrl":"10.1017/jme.2025.10223","url":null,"abstract":"<p><p>The second Trump administration has shaken the foundations of US leadership in global health, with this column assessing rapid shifts in global health governance. By analyzing how the administration's anti-science ethos, foreign assistance cuts, and multilateral disengagement have undermined global solidarity, the column considers the destabilizing impacts on global health and examines how other states, regional bodies, and international organizations are responding to this US decline. This examination reveals both strains for global health promotion and resilience within a changed governance landscape.</p>","PeriodicalId":50165,"journal":{"name":"Journal of Law Medicine & Ethics","volume":" ","pages":"102-106"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146054771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Balancing Progress and Precautions with Emerging Biotechnologies: Evaluating the Process of Gene Therapy Research Becoming \"Normal\".","authors":"Stephanie Solomon Cargill","doi":"10.1017/jme.2025.10210","DOIUrl":"10.1017/jme.2025.10210","url":null,"abstract":"<p><p>In recent years, we have seen an immense expansion in recombinant DNA, especially in its use in gene therapy applications. Throughout its history, the United States set up several mechanisms of national safety and ethical oversight for rDNA to ensure that we proceeded with its use appropriately. As our knowledge and experience with it grew, there has been increasing pressure to decrease the oversight and monitoring requirements for its use. In 2019, the National Institutes of Health amended the NIH Guidelines for Research Involving Recombinant DNA Molecules eliminated three national mechanisms for guidance, monitoring, and review of this biotechnology. Four years later, we revisit these changes and their implications for a current emerging biotechnology: xenotransplantation. By better understanding the motivations for these mechanisms and analyzing the test case, we argue that these changes have worrisome implications for our ethical oversight of emerging biotechnologies both in the realm of gene transfer technologies and beyond.</p>","PeriodicalId":50165,"journal":{"name":"Journal of Law Medicine & Ethics","volume":" ","pages":"1-9"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Conceptualizing Reproductive Donation: Developing Models of Egg and Sperm Donation and the Implications for Regulating Information Giving.","authors":"Lucy Frith","doi":"10.1017/jme.2026.10243","DOIUrl":"10.1017/jme.2026.10243","url":null,"abstract":"<p><p>There is little consensus on how to regulate information giving in reproductive donation - using donated gametes (eggs, sperm) to have children. Should gamete donors be anonymous or should donor-conceived individuals have access to their donor's identity, and at what age? What information should be available about donor siblings and other donor relations? And, crucially, how should this information giving be appropriately managed and regulated? Before we can answer these questions, we need to first understand what reproductive donation <i>is</i>. This paper sets out options for how reproductive donation can be conceptualized and develops a typology of different approaches, by categorizing reproductive donation into two main models: the biomedical and the psychosocial. These models provide a conceptual framework, a useful heuristic, for both understanding reproductive donation and critiquing regulation and oversight. The purpose of this paper is not to take a stand on which model is optimal; this is a matter for further debate. Rather, it provides clarification of what is at stake, and this can form the basis for coherent and justifiable approaches to the oversight and regulation of reproductive donation, instead of the patchwork of provisions that currently exist in many jurisdictions.</p>","PeriodicalId":50165,"journal":{"name":"Journal of Law Medicine & Ethics","volume":" ","pages":"216-228"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Bribery and the Global Pharmaceutical Industry: An Exploration of Patterns and Penalties in the Organisation for Economic Cooperation and Development Reports.","authors":"Jillian Kohler, Anaam Khan, Andrea Bowra","doi":"10.1017/jme.2026.10237","DOIUrl":"10.1017/jme.2026.10237","url":null,"abstract":"<p><p>Bribery by the pharmaceutical industry is one common manifestation of corruption that can be found in a pharmaceutical system. This study analyzes patterns of bribery in the global pharmaceutical industry through a systematic review of Organisation for Economic Co-operation and Development (OECD) Working Group on Bribery Phase Reports published between 1999 and February 2025. These reports document investigations and enforcement actions related to bribery across jurisdictions. An inductive thematic analysis was used to identify key patterns in cases implicating pharmaceutical firms. We found patterns across many of the cases we studied. For example, bribery was often approved by high-ranking managers. Also, the use of intermediaries and complicated corporate structures to obscure bribes. Multiple cases revealed the involvement of subsidiaries, third-party vendors, or shell companies that processed payments disguised as legitimate transaction. Reported bribes amounted to about US$12.6 million, with sanctions exceeding US$1.1 billion. Government officials, regulatory authorities, and healthcare providers were bribed through cash, gifts, luxury travel, and fraudulent research to gain market access, increase sales, or influence prescribing. These findings underscore the systemic nature of bribery in the pharmaceutical sector and call for stronger oversight and accountability to protect public trust and equitable medicine access.</p>","PeriodicalId":50165,"journal":{"name":"Journal of Law Medicine & Ethics","volume":" ","pages":"119-129"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146151139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Thinking Practically About How to Amplify Public Input in State Administrative Rulemaking.","authors":"Maxim Gakh","doi":"10.1017/jme.2026.10249","DOIUrl":"10.1017/jme.2026.10249","url":null,"abstract":"<p><p>Public input can provide state agencies with critical information as they adopt health-shaping rules. However, generating meaningful public input is challenging. State administrative procedure acts set out how state agencies must make rules and establish notice and comment processes to seek input into rulemaking. Notice and comment, though, is not conducive to meaningful public input. To enhance public input into state rules, government entities should not limit their engagement to notice and comment and should deploy, and maybe even amend, rulemaking processes to facilitate public input. Meanwhile, advocates and community members should prioritize state rulemaking, in all its phases, as part of their advocacy efforts.</p>","PeriodicalId":50165,"journal":{"name":"Journal of Law Medicine & Ethics","volume":" ","pages":"195-205"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"What We Don't Know Can Hurt: Ignorance Creation and Involuntary Commitment Data Initiatives.","authors":"M L N Kirby, Rocksheng Zhong","doi":"10.1017/jme.2026.10280","DOIUrl":"https://doi.org/10.1017/jme.2026.10280","url":null,"abstract":"<p><p>In \"Minding the Gap: The Absence of Pennsylvania's Involuntary Commitment Data,\" Gluckman et al. draw on agnotology and undone science to argue that unreported information about psychiatric commitments results in the disenfranchisement of vulnerable populations and call for better data on those affected by involuntary commitment. Their analysis assesses ignorance as an object, focusing on the qualities of granularity, scale, and intentionality to describe the negative space around absent data. We present a complementary agnotological framework centered on the passive and active processes through which ignorance is generated and maintained. We examine four elements that passively produce ignorance: conceptual frameworks, which determine whether committed persons are constructed as patients, public safety risks, adjudicated individuals, or stakeholders; community, whose exclusion yields epistemic injustice and weaker science; methodologies, including the non-neutral construction of data dashboards; and incentives, which shape what is profitable to know. We then discuss active agnotological forces, both harmful and virtuous, and how they influence what is knowable. We address privacy, an intentionally constructed ignorance whose protective purpose is contested in the context of involuntary commitment. We conclude by arguing that understanding how ignorance is created is critical in designing data initiatives that improve outcomes rather than perpetuating existing harms.</p>","PeriodicalId":50165,"journal":{"name":"Journal of Law Medicine & Ethics","volume":"54 3","pages":"339-343"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Public Health Limits of Medical Freedom.","authors":"James Hodge, Summer Ghaith, Amirala S Pasha","doi":"10.1017/jme.2026.10265","DOIUrl":"10.1017/jme.2026.10265","url":null,"abstract":"<p><p>Through emerging interpretations of individual \"medical freedoms,\" a panoply of state legislative bills seeks to undermine long-standing public health and health care requirements including recommendations to test, screen, treat, and vaccinate persons. To the extent these bills could upend decades of laws and policies protecting individual and communal health, especially among vulnerable individuals, they threaten the health - and freedoms - of all persons.</p>","PeriodicalId":50165,"journal":{"name":"Journal of Law Medicine & Ethics","volume":" ","pages":"409-413"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Value of Non-Domination in Supported Decision-Making for Research Participation for Individuals with Intellectual and Developmental Disabilities.","authors":"Dana Howard, Allison M McCarthy","doi":"10.1017/jme.2025.10193","DOIUrl":"10.1017/jme.2025.10193","url":null,"abstract":"<p><p>This paper argues that research ethics for individuals with intellectual and developmental disabilities must attend to the value of non-domination. First, we highlight the role of domination in the history of abusive research practices against individuals with intellectual and developmental disabilities, practices which directly led to existing protections for this vulnerable population. Second, we argue that existing protections do not adequately safeguard potential participants from domination in decision-making about whether to participate. This is a distinct concern from the well-established criticisms that existing protections may wrongfully exclude potential participants. Finally, we outline and defend an account of supported decision-making grounded in the value of non-domination in order to safeguard potential participants from domination. Our account nonetheless preserves supported decision-making's possibilities for greater inclusion of individuals with intellectual and developmental disabilities in research participation.</p>","PeriodicalId":50165,"journal":{"name":"Journal of Law Medicine & Ethics","volume":" ","pages":"56-66"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147532861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Benjamin C Silverman, Willyanne DeCormier Plosky, David H Strauss, Michael Ashley Stein, Leslie Francis, Barbara E Bierer
{"title":"Supported Decision-Making for Clinical Research Participants with Mental Illness.","authors":"Benjamin C Silverman, Willyanne DeCormier Plosky, David H Strauss, Michael Ashley Stein, Leslie Francis, Barbara E Bierer","doi":"10.1017/jme.2025.10191","DOIUrl":"10.1017/jme.2025.10191","url":null,"abstract":"<p><p>Federal disability anti-discrimination laws expect clinical trials to render study processes and sites accessible to potential participants, including through the provision of reasonable accommodations. Nonetheless, people with disabilities, and particularly people with mental illness, are often excluded from clinical trials. Supported decision-making, a strategy that allows people to select trusted others to help them understand and communicate decisions, is an important accommodation to further inclusion. However, because mental illness can be dynamic and vary widely in nature (e.g., diagnosis, symptom severity, functional impairment) and duration (e.g., short-term, intermittent, progressive, permanent), supported decision-making is neither a one-size-fits-all strategy nor one that can serve as a reasonable accommodation in every situation. While prior work on supported decision-making has focused predominantly on adults with intellectual and developmental disabilities or dementias, people with mental illness may also benefit from supported decision-making, although the variability in decision-making capacity in mental illness presents nuanced challenges. Here, we explore supported decision-making in the case of people with intermittent or episodic mental illness that may impact decision-making capacity to varying degrees at different times.</p>","PeriodicalId":50165,"journal":{"name":"Journal of Law Medicine & Ethics","volume":" ","pages":"85-93"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147534337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shannon Rempe, Jami Crespo, Madison Lee, Wendy E Parmet
{"title":"The Detrimental Shift: How the Judiciary is Eroding Our Health.","authors":"Shannon Rempe, Jami Crespo, Madison Lee, Wendy E Parmet","doi":"10.1017/jme.2026.10227","DOIUrl":"10.1017/jme.2026.10227","url":null,"abstract":"<p><p>For more than a century, US courts generally deferred to public health authorities, recognizing their expertise and the necessity of swift, science-based action to protect population health. This deference supported legal interventions that substantially increased life expectancy, reduced morbidity, and advanced health equity. In recent years, however, courts - particularly the Supreme Court - have retreated from this approach. Specifically, Supreme Court-driven doctrinal shifts favoring free exercise challenges, limiting deference to administrative agencies, and undermining equal protection have eroded public health authority and constrained governments' capacity to protect health and improve equity. Drawing on an empirical review of 30 lawsuits filed between January 2024 and May 2025 challenging governmental and institutional health equity initiatives, the paper demonstrates that the majority of these cases resulted in the invalidation or abandonment of equity-focused policies. These findings illustrate how contemporary judicial rulings are limiting governments' and institutions' authority and ability to safeguard health, particularly the health of our most vulnerable and marginalized populations. The paper concludes with a call to action: a coordinated public health strategy to build and sustain a jurisprudence that supports the fair, effective, and evidence-based exercise of public health authority.</p>","PeriodicalId":50165,"journal":{"name":"Journal of Law Medicine & Ethics","volume":"54 S1","pages":"62-69"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}