Ângela Alface, Graça Salomé, Khátia Munguambe, Troy D Moon, Esperança Sevene, Elizabeth Heitman
{"title":"Frontline Healthcare Professionals' Perceptions of the Duty to Care During the COVID-19 Pandemic: A Multi-Method Study in Mozambique.","authors":"Ângela Alface, Graça Salomé, Khátia Munguambe, Troy D Moon, Esperança Sevene, Elizabeth Heitman","doi":"10.1111/dewb.70048","DOIUrl":"10.1111/dewb.70048","url":null,"abstract":"<p><p>COVID-19 intensified ethical tensions between clinicians' duty to care and self-protection amid PPE shortages. We explored frontline healthcare professionals' perspectives in Maputo, Mozambique. Semi-structured interviews with healthcare professionals at four hospitals (April-June 2022) were recorded in Portuguese, transcribed, and thematically analyzed. Fixed-response items were captured in REDCap and summarized descriptively. Fifty-three respondents described varied perspectives on duty. Nearly half affirmed unconditional obligations grounded in professional ethics. Many framed duty as contingent on available PPE and institutional support; 8% were unsure. Themes included irregular PPE distribution, unequal training, and reliance on informal information, shaping perceived risk, preparedness, and responsibility. Quantitative summaries echoed these patterns: only 58% reported receiving training, and as PPE re-supply declined many felt exposed. Sustaining duty to care in resource-constrained settings during an outbreak requires reliable PPE provision, equitable and timely training, and trustworthy communication systems to protect workers and strengthen health-system resilience. Sustaining duty to care in resource-constrained settings during an outbreak requires reliable PPE provision, equitable and timely training, and trustworthy communication systems to protect workers and strengthen health-system resilience.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13396983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260340","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":"Bodily Reflections on Living Organ Donors Through the Lens of Confucian Body Philosophy.","authors":"Zhang Yan","doi":"10.1111/dewb.70050","DOIUrl":"https://doi.org/10.1111/dewb.70050","url":null,"abstract":"<p><p>The body of a living organ donor is not merely a medicalized object but also a vessel for nurturing familial ethical bonds and reconstructing the self. The Confucian perspective on the body offers a unique lens for interpreting the donor's physical and existential situation. Confucianism interweaves the act of bodily donation with the harmony and continuity of the moral individual within the family, the production of ethical relationships, and the formation of self-awareness, thereby providing a multidimensional interpretation of the donor's bodily experience. Through their bodily sacrifice, living donors manifest three dimensions of bodily existence: the situated body, the ethical body, and the practical body. Their bodily practices uphold the family's ethical order and assert personal agency, highlighting the role of emotional practices and moral embodiment in Chinese families' medical decision-making.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254318","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}
Ibrahim Aqtam, Mustafa Shouli, Hamdallah H Khaled, Ehab Tumeh, Khulud Mansor
{"title":"When Constraint Becomes Constitutive: Moral Distress and Ethical Coping Among Emergency Healthcare Workers in the West Bank, Palestine.","authors":"Ibrahim Aqtam, Mustafa Shouli, Hamdallah H Khaled, Ehab Tumeh, Khulud Mansor","doi":"10.1111/dewb.70052","DOIUrl":"https://doi.org/10.1111/dewb.70052","url":null,"abstract":"<p><p>Emergency healthcare workers in the West Bank deliver care under sustained structural constraint that limits access, resources, and clinical decision-making. This study examines how such conditions generate moral distress and shape ethical practice. A qualitative design was used. Nineteen semi-structured interviews were conducted with physicians and nurses in emergency departments across three cities. Data were analyzed using thematic analysis. Findings show a progression from acute, episode-based distress to chronic forms linked to persistent structural barriers, culminating in moral numbing. This trajectory reflects repeated exposure to situations where clinicians cannot act in line with professional obligations. Some participants reported that peer support and professional advocacy can partially interrupt this process, though these responses shift burden onto individuals. Moral distress in this context is structurally produced and sustained. Addressing it requires institutional and systemic responses rather than reliance on individual coping.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254324","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}
Aliki Edgcumbe, Adéle Strydom, Donrich Willem Thaldar, Michael Sean Pepper
{"title":"Exploring the Challenges and Legal Implications of Secondary Use of Health Data in South Africa.","authors":"Aliki Edgcumbe, Adéle Strydom, Donrich Willem Thaldar, Michael Sean Pepper","doi":"10.1111/dewb.70047","DOIUrl":"https://doi.org/10.1111/dewb.70047","url":null,"abstract":"<p><p>The sharing of health data advances knowledge, fosters innovation, and promotes evidence-based decision-making. This practice involves using existing data for collaborative research or for purposes other than those for which it was originally collected. In South Africa, the secondary use of health data has significant potential to inform policy decisions, advance scientific research, and address societal challenges. However, the use of health data for secondary purposes in the public health sector is faced with several challenges and legal complexities. This article examines these challenges and legal dimensions, with particular attention to the regulatory framework governing health data in South Africa, including issues of consent, privacy, data ownership, and intellectual property rights. Understanding these legal considerations enables stakeholders to navigate the complexities of secondary data use in an ethically sound and legally compliant manner.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254396","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":"Bioethics and the World Order: A Curious Coincidence Between Chinese and African Approaches.","authors":"Nancy S Jecker, Jing-Bao Nie, Anita Ho","doi":"10.1111/dewb.70049","DOIUrl":"https://doi.org/10.1111/dewb.70049","url":null,"abstract":"<p><p>The post-1945 world order is standardly pictured as a Westphalian system, in which each state is equal under the law with sovereign authority over its territories. This paper argues that the Westphalian system is changing and examines the implications for bioethics. We show that cross-border health, economic, ecologic, and sociopolitical risks defy a Westphalian view and propose an alternative approach that draws insights from Chinese-Confucian tianxia (all-under-heaven) and African ubuntu (humanness). Sections I and II introduce the Westphalian system and highlight key challenges. Sections III through V introduce Chinese and African views and identify convergences between them. Section VI proposes the narrative of a 'global village' to capture these convergences and demonstrates its advantages over a Westphalian narrative using the example of climate change, while also acknowledging the importance of retaining certain elements of the Westphalian system. Section VII concludes that African and Chinese approaches furnish a promising path forward for bioethics.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220790","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}
Herani S Dembu, Polly J Price, Jessica Sales, Liya Wassie
{"title":"Ethical Challenges of Obtaining Informed Consent: Qualitative Research on the Perspectives of Tuberculosis Patients Participating in Human Genomic Research in Ethiopia.","authors":"Herani S Dembu, Polly J Price, Jessica Sales, Liya Wassie","doi":"10.1111/dewb.70030","DOIUrl":"10.1111/dewb.70030","url":null,"abstract":"<p><p>The use of human genetic variation to comprehend complex diseases has also introduced several ethical, legal, and societal issues (ELSI). Despite the important contribution of Human Genome Research (HGR), full comprehension of these issues by all its stakeholders remains challenging. This research focused on exploring the understanding of research participants on the informed consent process of HGR. Nineteen Ethiopian TB patients, who participated in genomics research, were purposely selected for in-depth interviews. Their recorded responses were transcribed into text-based versions and analyzed thematically using MAXQDA Analysis Software. The patterns in the informed consent process showed the following themes: Therapeutic misconception, Limited clarity on perceived benefit, Partial understanding of third-party use, Addressed suspicion or concerns, Mixed feelings about sample and data extraction, Concerns about sample governance, Variations in information and understanding, Barriers and facilitators to comprehension, and Volunteerism and influencing factors. The findings incorporated both the strengths and challenges of the consenting process of a genomic study, while informing the need for ethical improvements.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13215234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950040","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":"The Commercialisation of Private Healthcare in Malaysia: Examining the Impact of Revenue Pressures and Defensive Medicine on Doctor's Professional Autonomy.","authors":"Astrid Sinarti Hassan, Rafiz Abdul Rani","doi":"10.1111/dewb.70034","DOIUrl":"https://doi.org/10.1111/dewb.70034","url":null,"abstract":"<p><p>The commercialisation of Malaysia's private healthcare sector has intensified conflicts between doctor's professional autonomy and financial pressures, raising ethical and legal concerns. Private practitioners increasingly face incentives to prioritise revenue-generating treatments, leading to defensive medicine, excessive testing and escalating healthcare costs. These financial and legal pressures undermine clinical independence, shifting the doctor-patient relationship toward a transactional model. This study employs a qualitative analytical approach to examine how financial imperatives shape medical decision-making and defensive practices in Malaysia's private healthcare sector. By assessing revenue-driven policies, litigation risks and their impact on professional autonomy, the analysis highlights the need for standardised guidelines, interdisciplinary collaboration and transparency in decision-making. Strengthening regulatory safeguards is crucial to preserving medical ethics while ensuring financial sustainability in private healthcare.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950090","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":"Of Muftis and Morals: Reviving Philosophical Discourse in Islamic Bioethics.","authors":"Ruaim Muaygil","doi":"10.1111/dewb.70035","DOIUrl":"https://doi.org/10.1111/dewb.70035","url":null,"abstract":"<p><p>Islamic bioethics is a recent, albeit growing, academic discipline. Despite commendable contributions, the field remains critically limited. Most notably, its methodology of strict application of Islamic law to ethical analyses and recommendations often lacks sufficient moral analysis, intellectual engagement, or social context. The practice's emphasis on religio-legal rulings- without an investigation of their underpinning moral values- has resulted in a field of inquiry devoid of robust normative foundations and dependent upon ineffective and unsubstantiated claims. This paper calls for a revival of Islamic philosophical discourse to enrich Islamic bioethical practice. Although once popularized by Medieval Muslim philosophers like Ibn Sina (Avicenna) and Ibn Rushd (Averroes), philosophical discourse has fallen out of favor in the Muslim world, largely due to a perceived tension with religion. This work highlights the rich tradition of philosophical discourse in the Medieval Muslim world, disproving claims of an inherent conflict between philosophy and Islam. Following an Islamic philosophical framework, three goals for Islamic bioethics are established. First, theoretical rigor aimed at continually re-assessing and re-understanding concepts integral to the practice of bioethics such as personhood, dignity, futility, autonomy, and justice. Second, a shift from essentialist understandings of the Quran- and other sources of Islamic law- to more contextual examinations in the formulation of ethical opinions. Third, an active and interdisciplinary collaboration between Muslim scholars in the determination of Islamic rulings on medical matters. Only when these goals are met is the practice of Islamic bioethics capable of meeting the needs of Muslim patients and clinicians.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935040","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":"No Surgery Without a License? Biopolitical Governance and Blood Donation Certificates in China.","authors":"Yuxin Dai","doi":"10.1111/dewb.70032","DOIUrl":"https://doi.org/10.1111/dewb.70032","url":null,"abstract":"<p><p>This article analyzes China's blood donation certificate system-whereby patients must present proof of donation for surgical priority-as a biopolitical technology of governance. Drawing on Foucault's framework, we examine how this informal practice operates through three mechanisms: temporal discipline that leverages medical urgency for compliance, territorial fragmentation that binds biological citizenship to local jurisdictions, and the paradox of anti-commodification that generates quasi-markets despite legal prohibitions on blood selling. The 2018 ban on mutual-aid donation eliminated legal mobilization pathways while institutional pressures persisted, transforming certificate requirements from biological exchange into administrative conditioning. We argue that the system's power lies precisely in the gap between formal voluntariness and practical compulsion-a space where biopower operates below legal accountability while extracting biological resources and cultivating civic complicity. This analysis illuminates how contemporary governance increasingly functions through administrative mechanisms that transform healthcare access from universal right into contribution-contingent privilege.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823060","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":"The Protective Precautionary Principle: Safeguarding the Vulnerable in Genome Editing.","authors":"Nucharee Wongsamut","doi":"10.1111/dewb.70031","DOIUrl":"https://doi.org/10.1111/dewb.70031","url":null,"abstract":"<p><p>This article provides the philosophical grounds for the Protective Precautionary Principle (PPP). This principle prioritizes protecting disadvantaged populations from the risks posed by new technologies, such as human heritable genome editing. I argue that the Protective Precautionary Principle is better suited for morally assessing applications of heritable genome editing than other formulations of the Precautionary Principle, including the Reasonable Precautionary Principle, the Rawlsian Core Precautionary Principle, and the Sufficientarian Precautionary Principle. The Protective Precautionary Principle permits heritable genome editing research only if it reflects a commitment to epistemic humility. Moreover, such research must avoid imposing significant risks on vulnerable populations unless substantial measures are in place to mitigate potential harms.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823099","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}