{"title":"Reproductive Autonomy, Graphic Reproduction, and <i>The Elephant in the Womb</i>.","authors":"Neeraj Abe, Sathyaraj Venkatesan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Reproductive autonomy is an integral aspect of female reproduction, but this autonomy is endangered by the control and surveillance of pregnant bodies by institutional structures, laws, and cultural norms. These restrictions deprive women of the freedom to make informed choices, ranging from decisions concerning prenatal care and reproductive procedures to abortion, violating fundamental human rights and bodily autonomy. This article examines how Kalki Koechlin's graphic memoir The Elephant in the Womb (2021) advances and nuances the discourses surrounding reproductive autonomy and offers insights into how graphic reproduction narratives contribute to developing reproductive rights discourse.</p>","PeriodicalId":54627,"journal":{"name":"Perspectives in Biology and Medicine","volume":"68 1","pages":"99-116"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Editor's Note.","authors":"Olaf Dammann","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":54627,"journal":{"name":"Perspectives in Biology and Medicine","volume":"68 1","pages":"1-2"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Philosophical in Confronting Rejection: Language Confusion in the Correspondence Between Editor and Author.","authors":"Neal S Young, William Child","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Publication of scientific and biomedical manuscripts in \"high impact factor\" (IF) journals is important in advancing careers, obtaining funding, and developing a field of research. Rejection by prestigious journals is not infrequent and usually painful, especially to young investigators. Reasons provided by an editor are often confusing. We assess the language of the rejection letter from a specific philosophical stance, originated by Ludwig Wittgenstein. Wittgenstein's late writings on language as usage and as inherent to human activity have profoundly influenced many of the humanities but have been less frequently applied to the sciences. However, Wittgenstein's ideas about language have relevance for understanding editorial correspondence and also, more broadly, for our thinking about scientific work and \"science.\"</p>","PeriodicalId":54627,"journal":{"name":"Perspectives in Biology and Medicine","volume":"68 1","pages":"3-21"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11974357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ira Bedzow, Matthew K Wynia, Rebecca Weintraub Brendel
{"title":"From Awareness to Action: teaching ethical decision-making to health-care leaders.","authors":"Ira Bedzow, Matthew K Wynia, Rebecca Weintraub Brendel","doi":"10.1353/pbm.2025.a962025","DOIUrl":"https://doi.org/10.1353/pbm.2025.a962025","url":null,"abstract":"<p><p>This article presents a novel pedagogical approach for teaching ethical decision-making to health-care leaders, offered through a collaboration between the Harvard Medical School Center for Bioethics and the Advanced Ethics in Leadership Program (AELP). The approach centers on the AELP Triple-A Framework, which guides participants through the process of identifying ethical issues, analyzing competing values, and developing strategic, context-sensitive action plans. Unlike traditional medical ethics education that often focuses on patient-physician relationships and clinical challenges, this model emphasizes leadership challenges within complex health-care organizations and trains clinicians and health leaders to respond ethically and effectively to systemic pressures. The framework is taught through immersive, implementation-focused workshops that combine pre-readings, case-based exercises, small-group collaboration, and iterative feedback. A featured case study on physician unionization illustrates how participants used the framework to move beyond technical solutions and engage deeply with questions of professional identity, institutional culture, and ethical leadership. Through this exercise, participants reconceived unionization not merely as a labor dispute but as a reflection of deeper organizational and moral tensions. The workshop model fosters the development of ethical leadership skills that are both principled and practical, enabling clinicians to navigate the evolving challenges of contemporary health care with moral clarity and strategic competence.</p>","PeriodicalId":54627,"journal":{"name":"Perspectives in Biology and Medicine","volume":"68 2","pages":"297-313"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jonathan M Cahill, Ian Marcus Corbin, Lydia S Dugdale
{"title":"Patients Before Profits: <i>restoring agency and mitigating moral injury in medicine</i>.","authors":"Jonathan M Cahill, Ian Marcus Corbin, Lydia S Dugdale","doi":"10.1353/pbm.2025.a962020","DOIUrl":"https://doi.org/10.1353/pbm.2025.a962020","url":null,"abstract":"<p><p>One of the major challenges facing health-care organizations is the well-being of clinicians. The goal of this article is to show how organizations are constrained by a neoliberal logic that has imported a factory-based organizational model into health care, resulting in alienation from work, feelings of betrayal and mistrust, and ultimately moral injury for physicians. If this damage is to be repaired, we must seek to understand the organizational sickness now afflicting health care and work to restore agency and trust to health-care workers and patients alike.</p>","PeriodicalId":54627,"journal":{"name":"Perspectives in Biology and Medicine","volume":"68 2","pages":"229-242"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Ethical Obligations of Health-Care Delivery Organizations: <i>a dynamic view</i>.","authors":"Kelsey N Berry, Lauren Taylor","doi":"10.1353/pbm.2025.a962015","DOIUrl":"https://doi.org/10.1353/pbm.2025.a962015","url":null,"abstract":"<p><p>The ethical obligations of health-care delivery organizations are complex, often generating deep disagreements about what justice requires of organizations operating within unjust social conditions. This article maps such disagreements onto the implicit tension between ideal and nonideal perspectives on justice and offers a dynamic way of bridging them. The ideal-nonideal tension and its potential resolution are illustrated with an organizational ethics case on social and medical care integration. By identifying and relating ideal and nonideal perspectives in a dynamic framework, the authors offer a new set of analytic and pragmatic tools by which health-care managers can navigate a broad range of complex questions of organizational ethics and health justice.</p>","PeriodicalId":54627,"journal":{"name":"Perspectives in Biology and Medicine","volume":"68 2","pages":"145-160"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Boosting Preclinical Parkinson's Disease Research in Africa.","authors":"Afolabi Clement Akinmoladun, Bright Kwaku Anyomi, Zainab Abiola Amoo, Jianshe Wei","doi":"10.1353/pbm.2025.a968847","DOIUrl":"https://doi.org/10.1353/pbm.2025.a968847","url":null,"abstract":"<p><p>Parkinson's disease (PD) is the fastest-growing neurodegenerative disease in the world and appears to be an emerging epidemic in Africa, where counteractive measures have become necessary. Previous reports have highlighted the limited epidemiological and clinical PD research in Africa but overlooked the poor preclinical PD research output of the continent. Because preclinical research is a bedrock for translating basic scientific research into clinical practice, a weak preclinical research foundation can hamper advancement in epidemiological and clinical investigations. The sparsity and low impact of preclinical PD research output in African countries compared to high-resource countries underscores the need for pragmatic measures to close the research gap. An improved funding of brain research in African institutions-ensuring provision of facilities and infrastructure for cutting-edge research, adequate remuneration for researchers, and policies to curtail brain drain-will stimulate preclinical PD research in Africa and contribute to stemming the spiraling global PD incidence.</p>","PeriodicalId":54627,"journal":{"name":"Perspectives in Biology and Medicine","volume":"68 3","pages":"401-413"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Patient Participation and Empowerment in Precision Medicine.","authors":"Austin Due","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Precision medicine functions by grouping patients along genetic, molecular, and related \"-omics\" factors. This stratification relies on large, growing databases of patient-volunteered information. Both private companies and government bodies incentivize patients to volunteer this genetic information by appealing to the creation of collaborative \"patient partnerships\" and the concept of empowerment. This article addresses two related questions: (1) what is the actual nature of patient participation in precision medicine research? and (2) is this participation really that empowering for the average patient? The author contends that the nature of this participation is best conceived of as merely contributory, which falls short of collaboration. Participation in precision medicine research does not entail sharing values, equal say in decisions, or shared benefit. The author also contends that there are important caveats to claims that patient participation in precision medicine is empowering. Empowerment is hindered by the type of participation, the practical use or actionability of genetic data, genetic literacy, the cost of precision drugs for patients that qualify for them, and bioethical considerations of informed consent.</p>","PeriodicalId":54627,"journal":{"name":"Perspectives in Biology and Medicine","volume":"68 1","pages":"22-36"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brittany L Greene, Delia C Allen, Yoram Unguru, Jonathan M Marron
{"title":"Boots on the Ground in Childhood Cancer Drug Shortages: a multilevel approach.","authors":"Brittany L Greene, Delia C Allen, Yoram Unguru, Jonathan M Marron","doi":"10.1353/pbm.2025.a962028","DOIUrl":"https://doi.org/10.1353/pbm.2025.a962028","url":null,"abstract":"<p><p>In recent decades, drug shortages have become more common and more impactful, and this has been particularly true in the field of pediatric oncology. This article provides a brief history of drug shortages, paying particular attention to shortages of critical cancer drugs. It gives background as to why this is such a vexing problem for hospitals and health-care organizations and how shortages often affect different institutions in different ways and similarly at the patient level. The authors provide specific examples of recent experiences with local, regional, and national collaborative efforts to navigate pediatric oncology drug shortages, identifying some of the successes of these groups, as well as their shortcomings, in achieving greater health-care justice. The article closes with reflections about the current state of affairs in childhood cancer drug shortages, identifying several areas that require further work and scholarship.</p>","PeriodicalId":54627,"journal":{"name":"Perspectives in Biology and Medicine","volume":"68 2","pages":"337-350"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Science and the Deepening of Historical Knowledge: The Case of the Haitian Revolution.","authors":"John Booss, Frank J Bia","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Over millennia, epidemics have wielded as much sway over human affairs as have wars, economic crises, and political upheavals. Devastating epidemics in the past have changed the course of history. This article focuses on the yellow fever epidemic of 1802 in St. Domingue to demonstrate how science has deepened our understanding of the epidemic, and hence of the Haitian Revolution. Genetics, affirming epidemiology, demonstrated that the origin of the virus was in Africa, and genomics demonstrated that the vector of yellow fever, the Aedes aegypti mosquito, evolved in the context of the ecological creation of the Sahara and the Sahel. The vector fed on humans and reproduced in man-made water containers, allowing transport to the Caribbean during the African slave trade. Serological studies in Africa later demonstrated that many African-origin slaves would have had adaptive immunity. French fighters did not, and they were decimated. The French withdrew, Haiti was created, and the Louisiana Purchase was executed.</p>","PeriodicalId":54627,"journal":{"name":"Perspectives in Biology and Medicine","volume":"68 1","pages":"54-69"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}