Developing World Bioethics最新文献

{"title":"What can be learned from the Global South on abortion and how we can learn?","authors":"Debora Diniz, Giselle Carino","doi":"10.1111/dewb.12385","DOIUrl":"10.1111/dewb.12385","url":null,"abstract":"<p>After the U.S. Supreme Court's decision opened the door to restrictions on abortion, there has been a surge in interest in international spaces in what we can learn from the Global South on how to overcome unjust barriers in health policies and regulations. As Global South thinkers with experience working on abortion, we have been embracing this interest as a genuine openness to transnational learning. However, the response is not straightforward.</p><p>It is not about importing solutions from one community to another. We can tell stories of community and women driven solutions to overcome the existing legal and policy barriers to accessing safe and legal abortion, such as the Green Wave movement in Argentina, the harm reduction strategy pioneered in Uruguay, hotline services in Peru or Nigeria, digital health solutions in Brazil or Poland, and accompaniment networks in Argentina, or Mexico. All these stories are lived realities of the creative resilience of those who have been surviving in some of the most restrictive settings in the world.</p><p>Throughout these stories from the Global South, there is a recurring theme of creative resilience and models of woman-to-woman care emerging at the community level and then later being embraced by researchers, policymakers, and institutions. It was poor Brazilian women who, in the 1980s, first identified misoprostol as an effective method for self-managed abortion.1 There was no white coat behind the discovery, but the desperate need of a woman seeking a safe means to have an abortion by reading the package leaflets of random medications to find those that showed increased risks of involuntary miscarriage. Forty years later, misoprostol is the main medication used to induce abortion worldwide, according to the World Health Organization. The stories of women who failed or died in this process of self-experimenting using different methods is unknown.</p><p>The validation of women's lived knowledge by science takes time and demands the emergence of a new discourse. A good example is what has been called “harm reduction counseling” to reduce the risk of unsafe abortion. In the Global South, the most popular model for providing harm reduction counseling is through hotlines. The person anonymously calls the service and receives evidence-based information about how to safely perform a self-managed abortion. Sharing information is possible even in restrictive settings, where the medicines are not legally available.</p><p>Women and other persons share abundant stories of how these hotlines helped them in a solitary selfcare experience surrounded by stigma and criminalization. However, too often, academics and policymakers do not consider these stories of lived experiences to have sufficient value or significance unless these stories have withstood certain methodological criteria. A recent systematic review analyzed the literature on abortion harm reduction interventions without the provision of medications, a","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":"23 1","pages":"3-4"},"PeriodicalIF":2.2,"publicationDate":"2023-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dewb.12385","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9178355","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":"Deliberate delays in offering abortion to pregnant women with fetal anomalies after 24 weeks' gestation at a centre in South Africa","authors":"Anita Kleinsmidt,&nbsp;Malebo Malope,&nbsp;Michael Urban","doi":"10.1111/dewb.12387","DOIUrl":"10.1111/dewb.12387","url":null,"abstract":"<p>South Africa has an abortion law which codifies the broad themes of reproductive rights set out in the Constitution of South Africa, other laws and national guidelines. Certain wording of the conditions in the Choice Act for abortion after 20 weeks' gestation, are open to interpretation, being ‘severe malformation of the fetus’ and ‘risk of injury to the fetus’. From 24 weeks onwards, abortion is carried out by feticide/induced fetal cardiac asystole (‘IFCA’) and subsequent induction of labour in South Africa. Some maternal-fetal units have developed guidelines to assist clinicians and patients in decision-making around eligibility for abortion after 20 weeks' gestation, given the broad terms in the law. We consider the guideline used by an institution in the Western Cape for abortion after 23 weeks and 6 days gestation, in terms of its alignment with the law on reproductive rights and its compliance with fair and transparent procedures. We also note its effect on respect for patients and on staff professionalism.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":"23 2","pages":"109-121"},"PeriodicalIF":2.2,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dewb.12387","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10051872","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":"Extreme poverty first: An argument on the equitable distribution of the COVID-19 vaccine in Peru","authors":"Carlos Augusto Yabar","doi":"10.1111/dewb.12391","DOIUrl":"10.1111/dewb.12391","url":null,"abstract":"<p>Effective vaccines for COVID-19 are already available to humankind. In Peru, 86 million doses were administered to cover the demand for 33 million Peruvian people. Hence, vaccination has been prioritized in groups: health personnel, subjects with pre-existing health conditions and those over 65 years of age. However, given the social problems and the public health situation in Peru, this work defends that the priority of vaccination should be focused on the population living in extreme poverty. The method used was an ethical argumentation on the distribution of scarce antiSARS-CoV2 vaccine in Peru. This argument is based on the analysis of the Peruvian population living in extreme poverty, which presents different layers of vulnerability, and that, in the face of an eventual SARS-CoV2 infection, these would be exacerbated one after the other, through a cascade effect. This scenario would give rise to new vulnerabilities to those already existing, causing greater damage. Vaccination efforts on this key population would give them the opportunity to continue to find ways to bring food to their homes, significantly reducing the risk of contagion in their environment and mitigating the devastating effect of the local diseases to which they are already exposed. Four objections related to this argument are raised with their corresponding responses. Priority access to the vaccine would significantly reduce the humanitarian harm to people living in extreme poverty, prevailing the principles of justice and equity.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":"24 2","pages":"97-101"},"PeriodicalIF":2.2,"publicationDate":"2023-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10536703","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 do healthcare researchers in South Asia publish in predatory journals? A scoping review","authors":"Komal Kashyap,&nbsp;Asmat Ara Islam,&nbsp;Joris Gielen","doi":"10.1111/dewb.12388","DOIUrl":"10.1111/dewb.12388","url":null,"abstract":"<p>Predatory journals offer the promise of prompt publication to those willing to pay the article submission or processing fee. However, these journals do not offer rigorous peer review. Studies have shown that a substantial share of corresponding authors in predatory journals come from South Asia, particularly India. This scoping review aims to assess what is known about the reasons why healthcare researchers working in South Asia publish in predatory journals. 66 reports (14 editorials, 20 letters, 5 research reports, 10 opinion articles, 14 reviews, 2 commentaries and 1 news report) were included in the data charting and analysis. The analysis of the reports identified three main reasons that made South Asian healthcare researchers publish in predatory journals: pressure to publish, lack of research support, and pseudo benefits. The review shows that predatory publishing in South Asia is a complex phenomenon. Combating predatory publications requires a holistic strategy that supersedes merely blacklisting these journals or listing criteria for journals that do meet academic standards.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":"24 2","pages":"54-65"},"PeriodicalIF":2.2,"publicationDate":"2023-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9213187","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 indigenous African cultural value of human tissues and implications for bio-banking","authors":"David Nderitu,&nbsp;Claudia Emerson","doi":"10.1111/dewb.12390","DOIUrl":"10.1111/dewb.12390","url":null,"abstract":"<p>Bio-banking in research elicits numerous ethical issues related to informed consent, privacy and identifiability of samples, return of results, incidental findings, international data exchange, ownership of samples, and benefit sharing etc. In low and middle income (LMICs) countries the challenge of inadequate guidelines and regulations on the proper conduct of research compounds the ethical issues. In addition, failure to pay attention to underlying indigenous worldviews that ought to inform issues, practices and policies in Africa may exacerbate the situation. In this paper we discuss how the African context presents unique and outstanding cultural thought systems regarding the human body and biological materials that can be put into perspective in bio-bank research. We give the example of African ontology of nature presented by John Samwel Mbiti as foundational in adding value to the discourse about enhancing relevance of bio-bank research in the African context. We underline that cultural rites of passage performed on the human body in majority of communities in Africa elicit quintessential perspective on beliefs about handling of human body and human biological tissues. We conclude that acknowledgement and inclusion of African indigenous worldviews regarding the human body is essential in influencing best practices in biobank research in Africa.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":"24 2","pages":"66-73"},"PeriodicalIF":2.2,"publicationDate":"2023-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10612717","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":"A market for diagnostic devices for extreme point-of-care testing: Are we ASSURED of an ethical outcome?","authors":"Mark Howard","doi":"10.1111/dewb.12389","DOIUrl":"10.1111/dewb.12389","url":null,"abstract":"<p>The World Health Organisation (WHO) is leading a global effort to deliver improved diagnostic testing to people living in low-resource settings. A reliance on the healthcare technologies marketplace and industry, shapes many aspects of the WHO project, and in this situation normative guidance comes by way of the ASSURED criteria — Affordable, Sensitive, Specific, User-friendly, Rapid and robust, Equipment-free, and Delivered. While generally improving access to diagnostics, I argue that the ASSURED approach to distributive justice — efficiency — and assessment of worth — productivity — may constrain efforts to deliver timely and accurate diagnosis in the developing world equitably by holding back new and innovative diagnostics and indirectly encouraging program and device design that may unfairly discriminate against certain groups. Even as we try to overcome the problem of global healthcare injustice, we may be entrenching disadvantage. I present my critique of ASSURED by 1) referencing Boltanski and Thévenot's theory of orders of worth to highlight the industrial and market foundations of the ASSURED guidelines; 2) comparing ASSURED with other normative guides that elevate the importance of civic responsibility in evaluations of distributive justice; 3) presenting a case study of the failed promise of microfluidic diagnostic devices. I conclude that a new approach to normative guidance is required to assess the value of developing world diagnostics, preferably, one that does not force global public goods into the marketplace.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":"24 2","pages":"84-96"},"PeriodicalIF":2.2,"publicationDate":"2023-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dewb.12389","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10553532","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":"Population, abortion, contraception, and the relation between biopolitics, bioethics, and biolaw in Iran","authors":"Kiarash Aramesh","doi":"10.1111/dewb.12386","DOIUrl":"10.1111/dewb.12386","url":null,"abstract":"<p>The Islamic government of Iran recently passed and announced a new law titled “Rejuvenation of the Population and Protection of the Family.” This legislation is a noteworthy example of biopolitics-influenced biolaw. In terms of abortion, contraception, prenatal screening, and population control, this law clearly contrasts with women's fundamental rights and freedoms and has significant health-related consequences for different sectors of the population. A historical review of the population policies of the Islamic Republic of Iran shows the occurrence of multiple abrupt and radical changes in such policies over the past four decades. This new law, promoted by religious biopolitics, is the most recent example, and places stringent limits on abortion. According to it, all decisions concerning abortion must be made in courts rather than in health clinics. Such courts are typically presided over by male religious scholars. This law also limits prenatal screening to the degree that will increase the rate of genetic defects, especially in the population's lower socioeconomic strata. By strictly limiting access to contraception, this law will increase the rate of unwanted pregnancies and sexually transmitted diseases. This paper argues that such an influence of biopolitics on biolaw contrasts with the principles of bioethics. Still, Iran's current institution of bioethics cannot address it effectively. Therefore, a new model of interaction between bioethics, biopolitics, and biolaw is needed to prevent the detrimental consequences of such pieces of legislation. Such a paradigm shift is demanded by the current “Woman, Life, Freedom” movement of the Iranian people.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":"24 2","pages":"129-134"},"PeriodicalIF":2.2,"publicationDate":"2023-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9105373","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":"Power and respect in global health research collaboration: Perspectives from research partners in the United States and the Dominican Republic","authors":"Corrinne Green,&nbsp;Jodi Scharf,&nbsp;Ana Jiménez-Bautista,&nbsp;Mina Halpern","doi":"10.1111/dewb.12384","DOIUrl":"10.1111/dewb.12384","url":null,"abstract":"<p>Research partnerships between institutions in the Global North and institutions in the Global South have many potential benefits, including sharing of knowledge and resources. However, such partnerships are traditionally exploitative to varying degrees. In order to promote equity in South-North research partnerships, it is necessary to learn from the experiences of researchers collaborating internationally. This study analyzed transcripts from eleven semi-structured qualitative interviews with researchers working at Clínica de Familia La Romana, an institution in the Dominican Republic with decades of experience with research and research partnerships with institutions from the Global North. The findings of this study suggest that respect for resources invested in research, as well as for the researchers and institutions themselves, are vital components to a successful global health research partnership. These findings have implications for individual research partnerships, as well as the policies of journals and institutions providing funding that affect these partnerships.</p>","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":"23 4","pages":"367-376"},"PeriodicalIF":2.2,"publicationDate":"2023-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10520734","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":"THANK YOU TO DEVELOPING WORLD BIOETHICS REVIEWERS","authors":"","doi":"10.1111/dewb.12379","DOIUrl":"10.1111/dewb.12379","url":null,"abstract":"","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":"22 4","pages":"298-299"},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42296014","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":"Counting the costs of the global north's COVID-19 policies: Lives vs life years","authors":"Udo Schuklenk","doi":"10.1111/dewb.12380","DOIUrl":"10.1111/dewb.12380","url":null,"abstract":"&lt;p&gt;Countries of the global north responded to the spread of COVID-19 typically with mitigation strategies aimed at flattening the curve. The laudable objectives were intended to reduce the number of people requiring care at any given time, as well as to prevent the health care system from collapsing under a tidal wave of sick people requiring intensive care in hospitals. Different countries have employed different mitigation strategies. Most had in common a shutting down of their borders for tourists and business travelers, or at least a dramatic reduction in international travel. Some countries even went so far as to imprison people in their own homes over extended periods of time, China being the paradigmatic examples of this.&lt;/p&gt;&lt;p&gt;The impacts of COVID-19 in the global north were significant. Economies contracted, health care for non-COVID-19 patients was delayed (for some patients irreversibly so), global supply chains were interrupted, schools switched to very suboptimal on-line learning, and so on. Currently reviews of such mitigation efforts both by academics as well as by various kinds of commissions of inquiries are ongoing, effectively comparing the number of COVID-19 deaths a given mitigation strategy has prevented, versus the number of prevented COVID-19 deaths in countries that deployed different mitigation strategies.&lt;/p&gt;&lt;p&gt;The question is, of course, why deaths should be &lt;i&gt;the&lt;/i&gt; relevant measure of success or failure, when in pretty much every other health policy instance one would focus on the loss of quality adjusted life years, or of disability adjusted life years. The reason why this issue matters is that these mitigation strategies all had their own costs. No doubt, unless a significant number of lives were directly lost as a result of a given COVID-19 mitigation strategy, a lower number of COVID-19 deaths than alternative mitigation strategies would have to be considered a success, and this is what happens today in review articles looking at these different responses.&lt;/p&gt;&lt;p&gt;Taking an alternative measure, say quality adjusted or disability adjusted life years, could quite conceivably change the outcomes of these reviews quite substantially. So, unsurprisingly, the measure one chooses often determines whether a particular policy response will be considered a success or a failure. Choosing deaths-prevented as the measure to be used is a normative choice that is far from self-evident, unless we decide that people's quality of life can be fully discounted. We would have to disregard then, for instance, the loss of quality learning environments that children encountered, the highest price being invariably paid by children of resource poor families. Equity campaigners who were busy arguing for particular equity considerations when it came to priority groups in the early days of the vaccine roll-outs had little to say about the harms affecting these children quite inequitably, with the greatest burdens being carried by the poorest","PeriodicalId":50590,"journal":{"name":"Developing World Bioethics","volume":"22 4","pages":"183-184"},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9877681/pdf/DEWB-22-183.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9196141","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}