Developing World Bioethics最新文献

{"title":"Low- and Middle-Income Countries Should Also Consider Assisted Dying.","authors":"Krishna Prasad Acharya, Sarita Phuyal","doi":"10.1111/dewb.12488","DOIUrl":"https://doi.org/10.1111/dewb.12488","url":null,"abstract":"","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When criminal law hinders public health emergency responses","authors":"Sinara Gumieri, Debora Diniz","doi":"10.1111/dewb.12484","DOIUrl":"10.1111/dewb.12484","url":null,"abstract":"<p>At the height of the COVID-19 pandemic, maternal mortality in Brazil nearly doubled. Between 2019 and 2021, the maternal mortality ratio in the country went from 59.1 deaths for every 100,000 live births to 117.4 deaths for every 100,000 live births.<sup>1</sup> This is a multicausal and complex issue involving biomedical factors as well as class and race-related social determinants that shape the low-quality and unequal access to prenatal and obstetric care in Brazil. On one hand, it is well documented that pregnant women are more likely to develop severe cases of COVID-19, especially if other medical conditions coexist.<sup>2</sup> On the other hand, it is also known that, in the first months of the pandemic, one in four Brazilian pregnant women who died from COVID-19 did not have access to an intensive care unit despite desperately needing it.<sup>3</sup> Multiple studies have shown that COVID-19-related maternal mortality risks were much higher for Black women and for women living in rural areas or away from urban centers in Brazil.<sup>4</sup></p><p>Even amid the uncertainties at the start of the pandemic, many studies drew attention to pregnancy termination or early delivery as part of the therapeutic measures to be considered for pregnant women severely ill from COVID-19.<sup>5</sup> Such guidance was somewhat reflected in some Brazilian protocols for the clinical management of pregnant people with COVID-19, which acknowledged that delivery and pregnancy termination decisions should be based on gestational age, maternal condition and fetal stability.<sup>6</sup> From a bioethical perspective, these biomedical criteria must be based on reproductive freedom, which means that women's autonomy is central to any decision made. The necessary legal framework was also in place: abortion in case of risk to life is recognized as a ground for legal abortion in Brazil since 1940. Additionally, several studies carried out since the early 2000s with doctors and medical students have shown that abortion in the event of life-threatening conditions is the best known and least rejected legal abortion ground among these professionals.<sup>7</sup></p><p>Legal abortion should have been an option for pregnant Brazilian women infected with COVID-19 and severely ill, but it wasn't. In the interviews we conducted with family members of 25 Brazilian pregnant or postpartum women who died of COVID-19 between 2020 and 2021,<sup>8</sup> it was clear that the few conversations about pregnancy termination as a therapeutic option were deeply impacted by stigma. It was difficult for pregnant women, their families, and medical professionals alike to understand and talk about abortion as a legitimate health need that could potentially save women's lives. Even when it was openly stated as a possibility, pregnancy termination was shrouded by the apprehension of something that can be considered morally reprehensible and often put off for the sake of pregnancy development, un","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":"25 2","pages":"83-84"},"PeriodicalIF":0.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dewb.12484","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethical imperatives in migration health: Justice and care in forced migration contexts.","authors":"Akm Ahsan Ullah","doi":"10.1111/dewb.12482","DOIUrl":"https://doi.org/10.1111/dewb.12482","url":null,"abstract":"<p><p>This article examines the ethical imperatives of migration health, focusing on displaced populations such as the Rohingya and Syrian refugees. Forced migration, driven by conflict, persecution, and climate disasters, presents profound ethical challenges to global healthcare systems. Utilizing deontological ethics, utilitarianism, and human rights-based approaches, the research addresses key principles like justice, equity, autonomy, and non-maleficence in healthcare provision for refugees. Empirical insights reveal significant barriers to healthcare access for displaced populations, including systemic discrimination, resource scarcity, and cultural constraints. Ethical dilemmas are particularly evident in resource allocation, prioritization of acute over chronic conditions, and neglect of mental health services. Through case studies from Rohingya camps in Bangladesh and Syrian refugee settings in Turkey and Jordan, the study highlights inequities in healthcare delivery, exacerbated by cultural and logistical challenges. The article emphasizes on culturally sensitive training, participatory healthcare design, and equitable resource distribution as critical pathways to ethical healthcare. Policy recommendations include prioritizing mental health, harmonizing national policies with international human rights law, and fostering global accountability frameworks.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inaccessibility of induced abortion in Türkiye: Bioethics in the shadow of reproductive governance.","authors":"Maide Barıș","doi":"10.1111/dewb.12481","DOIUrl":"https://doi.org/10.1111/dewb.12481","url":null,"abstract":"<p><p>In Türkiye, although induced abortion (I/A) is legal and recognized as a free public health service within the first ten weeks of pregnancy, reports and qualitative studies indicate that women encounter difficulties accessing I/A services in public health institutions. This paper suggests, based on various local reports and studies, that the denial of I/A in the last decade is, in part, attributable to various reproductive governance mechanisms that create a chilling effect on clinicians and institutions, making them unwilling to perform or provide abortions. Finally, based on a socio-political analysis of the status quo, this paper emphasizes that when discussing the inaccessibility of I/A or any topic related to reproductive ethics, it is essential that bioethical discussions must recognize and consider the role of politics and the reproductive governance mechanisms at play in reproductive healthcare, as they have significant ethical implications for the access and provision of these services. This approach allows for a deeper exploration of the less visible ethical implications of restrictive policies on legal reproductive services.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disproportionality and discrimination in public health emergencies: Lessons from Trinidad and Tobago's COVID-19 cremation ban.","authors":"Leon Budrie","doi":"10.1111/dewb.12483","DOIUrl":"https://doi.org/10.1111/dewb.12483","url":null,"abstract":"<p><p>At the height of the COVID-19 pandemic, the world experienced unprecedented mortality rates, forcing families to navigate the dual burden of grief and restrictive public health measures. These restrictions often disrupted traditional last rites, exacerbating emotional distress and burdens on the grieving. Trinidad and Tobago enforced regulations aimed at curbing COVID-19 which suspended citizens' constitutional rights; one such restriction was the ban on open-air cremations. While this restriction may have been inconsequential to many, it had profound effects on individuals for whom open-air cremation was an essential cultural and religious practice. An ethical analysis of the cremation ban prior to its implementation would have shown the measure to be ineffective, disproportionate, and discriminatory. This underscores the need to integrate public health ethics in public health emergency policy development to ensure interventions are evidence-based, equitable in burden distribution, and capable of maintaining public trust.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovative therapy in clinical practice: Ethical perspective from China.","authors":"Xiaonan Wang, Jichao Wang, Kun Li, Xiaomei Zhai","doi":"10.1111/dewb.12480","DOIUrl":"https://doi.org/10.1111/dewb.12480","url":null,"abstract":"<p><p>Innovative therapy, as a new paradigm of medical intervention deviating from standard routine practice, prioritizes the best interests of patients, offering alternative therapeutic pathways where standard treatments fail. In China, their application is increasing alongside advancements in medical technology. However, innovative therapy poses various ethical challenges in clinical settings, including misconceptions of being viewed as research rather than therapy, benefit-risk assessment complexities, conflicts of interest, and barriers to the development of effective regulatory strategies. This paper elucidates the concept of innovative therapy and critically examines these challenges within the Chinese clinical context, emphasizing patients' best interests. It proposes establishing guidelines and a comprehensive, adaptable regulatory framework to address the unmet healthcare-related needs of individual patients and mitigate risks. Engaging in these discussions provides some ethical insights from China on innovative therapy, serving as a reference for fostering the development and responsible utilization of innovative therapy.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should people be able to have access to medical assistance in dying to avoid living with Alzheimer's? Opinions from Mexico and Colombia.","authors":"Asunción Álvarez Del Río, Fabiola Orihuela-Cortés, Ma Del Pilar Santacruz-Ortega, Ma Luisa Marván","doi":"10.1111/dewb.12479","DOIUrl":"https://doi.org/10.1111/dewb.12479","url":null,"abstract":"<p><p>Growing population aging is accompanied by a growing fear of suffering dementia. Four hundred and thirty-six Mexican and Colombian adults completed a survey about their opinion on Medical Assistance in Dying (MAID) for patients with dementia, both in the early stage of the disease and in the advanced stage through an advance directive. In Colombia, MAID is allowed while in Mexico it is banned. The main reasons given by those who agreed with MAID were \"right to decide\" and \"avoiding suffering.\" Religious beliefs were the main reason for disagreeing. More Mexicans than Colombians agreed with MAID possibly because Mexicans showed a lower degree of religiosity, and also possibly because there are religious movements against euthanasia in Colombia. The results were discussed considering the current debate about MAID in cases of dementia in general, and about requesting it through an advance directive for patients in the advanced stage of the disease.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What in the world is global health? A conceptual analysis.","authors":"Alberto Giubilini","doi":"10.1111/dewb.12478","DOIUrl":"https://doi.org/10.1111/dewb.12478","url":null,"abstract":"<p><p>This article suggests that the concept of global health - and to an extent the field that it designates - is problematic in various ways. Within public health, the concept of the 'public' has been widely investigated. However, \"global health\" has been introduced in academic, policy, and public discussion with comparably lower level of conceptual, philosophical scrutiny. Thus, while public health ethics addresses the ethical and political issues that the different meanings of 'public' allow to identify, global health ethics tends to leave ethical and political issues raised by the concept of 'global health' implicit and insufficiently analysed. I will briefly present the debate around the 'public' in public health, describing some of the ethical and political questions that might arise, depending on what 'public' is taken to mean. I will then use this discussion as a conceptual map for an analogous analysis of the concept of 'global' in global health. I will discuss what dimensions 'global' adds to the concept of 'public'. In the second part of the article, I will briefly introduce the philosophical debate on the concept of health, before suggesting that its cultural sensitivity makes it ill-suited to be qualified as 'global'. All in all, this article wants to bring to light the ethical implications that the terminology of 'global health' introduces in academic research and public policy that goes under that heading, as a first step towards better defining the ethical contours of this discipline.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding the bioethical dialogue on abandoned cryopreserved embryos in South Africa","authors":"Carlos M. Ardila","doi":"10.1111/dewb.12477","DOIUrl":"10.1111/dewb.12477","url":null,"abstract":"","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":"25 2","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why the South African National Health Research Ethics Council is wrong about ownership of human biological material and data.","authors":"Donrich Thaldar, Uyanda Maboea, Amy Gooden","doi":"10.1111/dewb.12475","DOIUrl":"https://doi.org/10.1111/dewb.12475","url":null,"abstract":"<p><p>The South African National Health Research Ethics Council (NHREC) states in its 2024 Ethics Guidelines that human biological material (HBM) and data cannot be privately owned under South African law. This position conflicts with established legal principles, guidelines by the Health Professions Council of South Africa (HPCSA), and South African university policies, all of which support private ownership of HBM and data. Private ownership is not only legally sound but also ethically necessary, providing a framework for accountability, ensuring fair recognition of institutional contributions, and enabling responsible custodianship over these valuable resources. The NHREC's denial of private ownership of HBM and data undermines South African research institutions' ability to control their research assets and leaves them vulnerable to exploitation by foreign entities. The NHREC should issue a corrigendum to delete its incorrect position on private ownership of HBM and data.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}