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Sexual violence, the state, and the justice system: An unfolding tale of moral degradation in India. 性暴力、国家和司法系统：印度道德堕落的一个正在展开的故事。
Indian journal of medical ethics Pub Date : 2026-01-01 DOI: 10.20529/IJME.2026.002
Sunita Sheel Bandewar
{"title":"Sexual violence, the state, and the justice system: An unfolding tale of moral degradation in India.","authors":"Sunita Sheel Bandewar","doi":"10.20529/IJME.2026.002","DOIUrl":"10.20529/IJME.2026.002","url":null,"abstract":"<p><p>On December 23, 2025, the Delhi High Court (HC) issued an order suspending the life sentence of Kuldeep Singh Sengar - convicted in 2019 for the rape of a minor Dalit girl, and for the death of her father, following an assault in custody by Sengar's brother and others - and approving his bail application in the rape case [1]. On December 29, 2025, after public protests, the Supreme Court of India (SC) stayed the Delhi High Court order [2], giving some respite to the survivor and her family. Even so, the Delhi HC order raises several concerns which could weaken public trust in the justice delivery system, particularly regarding sexual crimes against women and children. The Delhi HC decided that, regardless of the serious crime, as a legislator, Sengar could not be considered a \"public servant\". Hence, a life sentence for child rape by a public servant, mandated by the law, was not applicable to Sengar. Further, as he had already served jail time for over 7 years - the minimum sentence for rape of a child - the HC remitted the sentence [1].</p>","PeriodicalId":517372,"journal":{"name":"Indian journal of medical ethics","volume":"XI 1","pages":"3-5"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147380393","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}
引用次数: 0
Conclusiveness of DNA Reports in Indian rape cases: procedural challenges and judicial caution. 印度强奸案DNA报告的结论性：程序挑战和司法谨慎。
Indian journal of medical ethics Pub Date : 2026-01-01 Epub Date: 2025-10-17 DOI: 10.20529/IJME.2025.077
Shibam Talukdar
{"title":"Conclusiveness of DNA Reports in Indian rape cases: procedural challenges and judicial caution.","authors":"Shibam Talukdar","doi":"10.20529/IJME.2025.077","DOIUrl":"10.20529/IJME.2025.077","url":null,"abstract":"<p><p>DNA profiling is considered a scientifically reliable tool for identifying perpetrators and exonerating the innocent. However, its role in Indian rape cases is generally regarded as corroborative rather than conclusive. Judicial scepticism stems from the likelihood of procedural deviations in sample collection, preservation, and handling, along with a preference for traditional evidence such as eyewitness testimony. Inconsistent judicial interpretation, multiplicity of forensic protocols, judicial backlogs, inadequate infrastructure/workforce, and delay tactics compound the problem. Statutory provisions permit DNA sample collection without defining \"DNA profile\", the use of force in obtaining bodily measurements, and the prolonged retention of DNA data. These factors raise concerns over genetic privacy, human dignity, and informational overreach. The probative value of DNA evidence remains contingent upon the adoption of uniform and binding forensic protocols with embedded legal sanction, effective regulatory oversight, strict adherence to prescribed standards, infrastructure/trained manpower augmentation, and judicial sensitisation to evolving DNA technologies.</p>","PeriodicalId":517372,"journal":{"name":"Indian journal of medical ethics","volume":"XI 1","pages":"35-41"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147380385","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}
引用次数: 0
Unwalling the clinic: Redefining medicine through palliative care. 解除诊所的壁垒：通过姑息治疗重新定义医学。
Indian journal of medical ethics Pub Date : 2026-01-01 Epub Date: 2025-04-09 DOI: 10.20529/IJME.2025.026
Meghna Haridas
{"title":"Unwalling the clinic: Redefining medicine through palliative care.","authors":"Meghna Haridas","doi":"10.20529/IJME.2025.026","DOIUrl":"10.20529/IJME.2025.026","url":null,"abstract":"<p><p>This reflective essay explores my experience as a nonmedical volunteer at a palliative care centre, in Elamkulam Panchayat, in the Malappuram district of Kerala for two weeks in October 2023 as a master's student of Medical Humanities. It examines how palliative care functions in a community setting, addressing the needs of terminally ill patients. Through direct observations and interactions, I reflect on how the decentralised, interdisciplinary and flexible nature of palliative care service transcends some limitations of modern clinical medicine, offering a holistic approach that embraces individual subjectivity, challenges hierarchical structures, and fosters a profound, compassionate connection with patients.</p>","PeriodicalId":517372,"journal":{"name":"Indian journal of medical ethics","volume":"XI 1","pages":"60-62"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147380377","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}
引用次数: 0
Starting from the end: The cemetery as a learning venue. 从结尾开始：把墓地作为学习的场所。
Indian journal of medical ethics Pub Date : 2026-01-01 Epub Date: 2025-08-14 DOI: 10.20529/IJME.2025.063
Thalia Arawi
{"title":"Starting from the end: The cemetery as a learning venue.","authors":"Thalia Arawi","doi":"10.20529/IJME.2025.063","DOIUrl":"10.20529/IJME.2025.063","url":null,"abstract":"<p><p>Medical students encounter patient deaths throughout their training and tend to cope with death under the pretence of curing to fight off the imminence of death, rarely pondering the true meaning of mortality. This assumed numbness often makes them harsh, insecure, and somehow oblivious to the human plight of patients and their families. The Covid-19 pandemic has made the need for reflection on mortality even more significant. This commentary discusses a cemetery visit as part of the clinical ethics training of medical students. On this \"existential trip\", students address their perceptions, fears, and beliefs about death and dying, opening their eyes to the reality of the profession of medicine. This form of experiential learning aims to awaken students to the inevitable fate they share with their patients, dispelling the illusion of being infallible physicians, thus helping shape empathetic future physicians sensitised to the unuttered distress of dying patients and their caregivers.</p>","PeriodicalId":517372,"journal":{"name":"Indian journal of medical ethics","volume":"XI 1","pages":"25-29"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147380410","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}
引用次数: 0
To treat or not to treat: A toolkit-based ethics consultation in a newborn. 治疗还是不治疗：基于工具包的新生儿伦理咨询。
Indian journal of medical ethics Pub Date : 2026-01-01 Epub Date: 2025-12-17 DOI: 10.20529/IJME.2025.095
Smriti Khanna, Shruti Vyas, Veronique Dinand, Roop Gursahani, Kiran More
{"title":"To treat or not to treat: A toolkit-based ethics consultation in a newborn.","authors":"Smriti Khanna, Shruti Vyas, Veronique Dinand, Roop Gursahani, Kiran More","doi":"10.20529/IJME.2025.095","DOIUrl":"10.20529/IJME.2025.095","url":null,"abstract":"<p><p>Congenital Diaphragmatic Hernia (CDH) is usually diagnosed prenatally. Despite advances, the prognosis remains poor for severe CDH in many healthcare settings, and many require transition to palliative care. This transition can be an ethical dilemma especially in cases of conflict between stakeholders. A resolution can be accomplished with clinical ethics consultations, but these are rarely available in India. This case report describes how such ethical dilemmas can be resolved by applying paediatric ethics principles in conjunction with Jonsen's four-box model.</p>","PeriodicalId":517372,"journal":{"name":"Indian journal of medical ethics","volume":"XI 1","pages":"55-59"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147380383","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}
引用次数: 0
Evolution of post-trial access in India: An analysis of ethical and regulatory guidelines. 印度试验后获取途径的演变：伦理和监管准则的分析。
Indian journal of medical ethics Pub Date : 2026-01-01 Epub Date: 2025-09-09 DOI: 10.20529/IJME.2025.070
Nithya J Gogtay, Vijaya L Chaudhari, Prachi V Bhoir, Nikita S Sawant, Urmila M Thatte
{"title":"Evolution of post-trial access in India: An analysis of ethical and regulatory guidelines.","authors":"Nithya J Gogtay, Vijaya L Chaudhari, Prachi V Bhoir, Nikita S Sawant, Urmila M Thatte","doi":"10.20529/IJME.2025.070","DOIUrl":"10.20529/IJME.2025.070","url":null,"abstract":"<p><strong>Background: </strong>Post-trial access (PTA) is an important element of any ethics or regulatory guidance document. It was first introduced in the Declaration of Helsinki (DoH) in the year 2000 but has only recently gained momentum. The objective of this narrative review was to examine the evolution of PTA in Indian bioethical and regulatory guidelines.</p><p><strong>Methods: </strong>Websites of all Indian government agencies that issue ethics guidelines periodically as well as the website of the Indian regulator was searched by three authors and the guidelines downloaded. Identification of PTA in the guidelines was done by all authors and a consensus was reached. The Scale for the Assessment of Narrative Review Articles (SANRA) criteria were used as the reference framework.</p><p><strong>Results: </strong>The Indian Council of Medical Research (ICMR) guidelines of 2000 and 2006 mention PTA, though the most comprehensive coverage can be seen in the 2017 ICMR guidelines. This was followed by a good coverage of PTA in the New Drugs and Clinical Trials (NDCT) rules of 2019. Other guidelines have also briefly alluded to PTA.</p><p><strong>Conclusion: </strong>In the years to come, Indian guidelines must evolve beyond PTA towards post-trial provisions (as introduced in DoH, 2024) or post-trial care, which are broader in their vision and go beyond the individual participant in a clinical trial.</p>","PeriodicalId":517372,"journal":{"name":"Indian journal of medical ethics","volume":"XI 1","pages":"6-9"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147380416","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}
引用次数: 0
The ethical and practical challenges of rebuilding Gaza's health system. 重建加沙卫生系统的道德和实际挑战。
Indian journal of medical ethics Pub Date : 2026-01-01 Epub Date: 2025-10-30 DOI: 10.20529/IJME.2025.081
Kasturi Sen, Eduardo Missoni
{"title":"The ethical and practical challenges of rebuilding Gaza's health system.","authors":"Kasturi Sen, Eduardo Missoni","doi":"10.20529/IJME.2025.081","DOIUrl":"10.20529/IJME.2025.081","url":null,"abstract":"<p><p>As public health practitioners with experience of working in conflict zones, including in the Gaza Strip, we felt compelled to write this Commentary. The relative silence of the international public health community regarding the ongoing mayhem and genocide by Israel in Gaza has been deafening. In stark contrast, medics from Gaza and the region have responded massively both with pleas for an end to the genocide and also by showing us how they are coping with bare essentials in a largely destroyed health system, at the epicentre of the conflict illustrating their deep commitment to preserving life in the midst of a genocide. The voice of the medical community in the global North must rise and change so that a North-South divide on the value of human life does not evolve into a 21st century norm. This major ethical challenge is not just for Gaza but for the global public health community. We explore the ethical imperatives and immense challenges of rebuilding Gaza's health system postconflict. Since the submission of this paper in May 2025, a ceasefire was called for in Gaza (October 10, 2025), but relentless destruction continues with impunity. Subsequently, the number of deaths, injured and displaced people have increased substantially, but this data could not be included in this commentary. However, the major challenges of rebuilding Gaza's health system will remain at the forefront of any efforts for reconstruction.</p>","PeriodicalId":517372,"journal":{"name":"Indian journal of medical ethics","volume":"XI 1","pages":"19-24"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147380421","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}
引用次数: 0
Drug safety: The roles of big data and clinical experience. 药品安全：大数据与临床经验的作用。
Indian journal of medical ethics Pub Date : 2025-10-01 DOI: 10.20529/IJME.2025.017
David Healy
{"title":"Drug safety: The roles of big data and clinical experience.","authors":"David Healy","doi":"10.20529/IJME.2025.017","DOIUrl":"10.20529/IJME.2025.017","url":null,"abstract":"<p><p>Following the pharmacovigilance crises of 2004 involving the use of Vioxx and antidepressants in minors, medicine regulators turned to big data, also called real-world evidence, to support their efforts to establish the safety of treatment protocols. In many areas of drug development, big data can clearly play a part; but to date, it has not helped resolve safety issues. Developments in artificial intelligence may help clarify the respective roles of big data and clinical expertise in pharmacovigilance in surprising ways.</p>","PeriodicalId":517372,"journal":{"name":"Indian journal of medical ethics","volume":"X 4","pages":"297-301"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145454467","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}
引用次数: 0
Scientific advances facilitate formulation and practical implementation of climate-conscious clinical medical ethics. 科学进步促进了气候意识临床医学伦理的制定和实际实施。
Indian journal of medical ethics Pub Date : 2025-10-01 DOI: 10.20529/IJME.2025.066
Bor Luen Tang
{"title":"Scientific advances facilitate formulation and practical implementation of climate-conscious clinical medical ethics.","authors":"Bor Luen Tang","doi":"10.20529/IJME.2025.066","DOIUrl":"10.20529/IJME.2025.066","url":null,"abstract":"<p><p>Global climate change due to anthropogenic carbon emissions has created and deepened problems in medicine and public health, such as ecological upheavals and ambient heat-associated health detriments. The fields of biomedicine and biomedical ethics must pay heed to problems arising from global climate change, but such reflection on research into climate change-responses appear inadequate [1]. A number of authors have proposed changes or climate change-related extensions to existing biomedical ethics frameworks. These range from Hantel and colleagues' scope-expanding and climate-conscious updates [2] to Jonsen and Siegler's four-topics principles of clinical medical ethics (CME) (\"medical indications\", \"preferences of patients\", \"quality of life\", and contextual features) [3], which are lucid and informative. However, prescriptive theoretical frameworks have limits in their epistemic construction and practical constraints in implementation. Below, I shall cite three examples that illustrate how advances in science and research are needed to facilitate climate-conscious extensions to more classical CME.</p>","PeriodicalId":517372,"journal":{"name":"Indian journal of medical ethics","volume":"X 4","pages":"342-343"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145454457","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}
引用次数: 0
Navigating the ethical challenges in the care of a critically ill infant. 应对危重婴儿护理中的伦理挑战。
Indian journal of medical ethics Pub Date : 2025-10-01 DOI: 10.20529/IJME.2025.023
Aliyyah Mohammad Khuzaini, Najwa Farhana Binti Norman, Muhammad Abubakar Uthman Mohd Nazri, Hafizah Zainal Abidin
{"title":"Navigating the ethical challenges in the care of a critically ill infant.","authors":"Aliyyah Mohammad Khuzaini, Najwa Farhana Binti Norman, Muhammad Abubakar Uthman Mohd Nazri, Hafizah Zainal Abidin","doi":"10.20529/IJME.2025.023","DOIUrl":"10.20529/IJME.2025.023","url":null,"abstract":"<p><p>This case presents the challenges faced in managing a premature infant with multiple unexplained neuromuscular symptoms. The discussion focuses on the ethical dilemmas surrounding the initiation of palliative care in the absence of a clear diagnosis. Key ethical questions include the appropriateness of continuing intensive care when the prognosis is uncertain, and the role of parental autonomy in making informed decisions. This case underscores the importance of ongoing ethical deliberation and sensitive communication in neonatal end-of-life care.</p>","PeriodicalId":517372,"journal":{"name":"Indian journal of medical ethics","volume":"X 4","pages":"322-324"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145454478","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}
引用次数: 0
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