Legacy anatomical collections are literally “skeletons in the closet” in many anatomy, anthropology, and other institutions where human tissues may be found. There are not only bones in these collections but fetuses, histological slides, and other human tissues that were obtained decades ago in a very different ethical landscape. The provenance of these tissues is often unknown, with documentation missing and no other means of identifying their origin or history. After recent scandals regarding the abuse of tissues of the deceased increased public attention, several American professional organizations developed new recommendations for the use, storage, and disposition of these human tissues. This manuscript discusses the formation, operations, and conclusions of guidelines from two associations: The American Association for Anatomy Recommendations for the Management of Legacy Anatomical Collections (Cornwall et al. 2024a) and the American Anthropological Association Commission for the Ethical Treatment of Human Remains Final Report (Agarwal et al. 2024). These recommendations inform the memberships of their respective organizations on the proper treatment of human remains and they also lay the foundation and framework for the proper ethical oversight of legacy human tissues in many other domains.
In The Community of Those Who Have Nothing is Common, Alfonso Lingis begins his exploration of the “other community” with the story of those dying in hospital. The spectre of mortality is constricting and limiting; yet, within the milieu of finality, individuals are freed from many constraints, opening doors to new possibilities. In facing our own mortality, we recognize “others” grappling, like ourselves, with insoluble questions, while trying to work out how to act. In the darkness, chaos and terror of diagnosis and treatment, communities are thereby formed of individuals who have nothing but their cancers in common, who choose to face their deaths and the impending nothingness together. Utilizing empirical data from an ethnographic study of cancer patients in a hospital, we reflect on Lingis’ notion of the other community, seeking to respond to his questions: “Is the death that isolates each one a common death? And can it be identified as nothingness?”.
A steadfast commitment to scientific integrity should be a fundamental quality of all researchers and is central to their pursuit of knowledge for societal benefit. Failure to uphold this integrity can have serious consequences for the researchers involved and the wider community, as demonstrated by scientific publications that report data or results derived from questionable and unethical practices. This study aimed to evaluate retraction rates in scientific literature within the fields of psychiatry and psychology. Using a bibliometric approach, the study analysed retracted articles indexed in the Web of Science over the past ten years, identifying integrity issues in the fields of psychology and psychiatry and categorizing retractions by year, country, journal, category, and index. The results show that, although the number of retractions in psychology and psychiatry has increased, they still represent a smaller proportion of the total number of retractions than other scientific disciplines. In many cases, the reason for retraction is scientific misconduct (65.56 per cent), with only 23.33 per cent of retractions initiated for honest errors. Most of the time (52.22 per cent), editors initiate the retraction. We discuss these results, paying particular attention to the direct and indirect harm caused to individuals in line with the ethical principle of non-maleficence. This highlights the importance of avoiding the citation of retracted publications as evidence in decision-making processes related to mental health interventions.
A steadfast commitment to scientific integrity should be a fundamental quality of all researchers and is central to their pursuit of knowledge for societal benefit. Failure to uphold this integrity can have serious consequences for the researchers involved and the wider community, as demonstrated by scientific publications that report data or results derived from questionable and unethical practices. This study aimed to evaluate retraction rates in scientific literature within the fields of psychiatry and psychology. Using a bibliometric approach, the study analysed retracted articles indexed in the Web of Science over the past ten years, identifying integrity issues in the fields of psychology and psychiatry and categorizing retractions by year, country, journal, category, and index. The results show that, although the number of retractions in psychology and psychiatry has increased, they still represent a smaller proportion of the total number of retractions than other scientific disciplines. In many cases, the reason for retraction is scientific misconduct (65.56 per cent), with only 23.33 per cent of retractions initiated for honest errors. Most of the time (52.22 per cent), editors initiate the retraction. We discuss these results, paying particular attention to the direct and indirect harm caused to individuals in line with the ethical principle of non-maleficence. This highlights the importance of avoiding the citation of retracted publications as evidence in decision-making processes related to mental health interventions.
What is our responsibility to the absent presence of the dead and what is the nature of the encounter with those who persist in haunting us, not through personal memories but as ungraspable remainders of lives past? I approach the issue through a reflection on bioarchives, not as places of either continuing medical education or of somewhat voyeuristic curiosity but as sites that increasingly demand that we consider what kind of response is owed. In employing a hauntological ethics that refuses the distinction between the putative passivity of seemingly inanimate matter and the agency of vibrant life, the binaries of past and present; past, present, and future; living and non-living; and absence and presence are all rendered uncertain evoking instead a non-linear temporality. I offer a philosophically based review using Derrida's notion of spectrality and hauntology and the Deleuzian sense of all life as a dynamic assemblage without beginning or end, before turning to a tentative exploration of the potential of bioart as a possible bridging point to a new imaginary. In each mode, the task is to attempt an ethical reconception of the bioarchives without expectation of any final resolution. The immediate reference point is the current reappraisal in many medical institutions and museums of the status of historical biomaterials, including the preserved bones and tissues of the dead and the wax moulages taken from the diseased bodies of social outcasts.
Several years ago Lipworth, et al. (2023) indicated that emerging evidence reveals a multitude of mistakes and a lack of scientific rigour on all things COVID-19, including issues around the vaccines. Examining some of the most recent evidence, I explain that Lipworth, et al. were correct in hypothesizing that numerous mistakes have been made regarding the vaccines' development, recommendation, media coverage, and mandating.
Urgent decision-making during the early COVID-19 pandemic raised complex ethical challenges, in particular concerning how to reach and include marginalized populations. To examine these issues, we conducted a qualitative study based on twenty-three semi-structured interviews with pandemic decision-makers and representatives of marginalized populations in Germany and Israel, focusing on decisions made in 2020 before vaccines were available. Key ethical themes emerged, including decision-making with ethical relevance under intense time pressure, the dominance of biomedical framings often at the expense of social considerations, inadequate attention to populations in bio-psycho-socially vulnerable positions, and the exclusion of stakeholders from decision-making processes. These findings have critical normative significance, highlighting issues of justice in the distribution of burdens and benefits, underscoring the importance of epistemic humility in acknowledging uncertainty and diverse forms of expertise, and affirming the moral obligation to integrate considerations of psycho-social vulnerabilities into public health. To inform future policy, we recommend establishing equitable governance structures to ensure broader stakeholder representation, implementing inclusive communication strategies to reach marginalized groups, and strengthening ethically informed crisis preparedness. Such measures can better align urgent public health decision-making with principles of justice, protection from harm, inclusion, and moral responsibility.
Urgent decision-making during the early COVID-19 pandemic raised complex ethical challenges, in particular concerning how to reach and include marginalized populations. To examine these issues, we conducted a qualitative study based on twenty-three semi-structured interviews with pandemic decision-makers and representatives of marginalized populations in Germany and Israel, focusing on decisions made in 2020 before vaccines were available. Key ethical themes emerged, including decision-making with ethical relevance under intense time pressure, the dominance of biomedical framings often at the expense of social considerations, inadequate attention to populations in bio-psycho-socially vulnerable positions, and the exclusion of stakeholders from decision-making processes. These findings have critical normative significance, highlighting issues of justice in the distribution of burdens and benefits, underscoring the importance of epistemic humility in acknowledging uncertainty and diverse forms of expertise, and affirming the moral obligation to integrate considerations of psycho-social vulnerabilities into public health. To inform future policy, we recommend establishing equitable governance structures to ensure broader stakeholder representation, implementing inclusive communication strategies to reach marginalized groups, and strengthening ethically informed crisis preparedness. Such measures can better align urgent public health decision-making with principles of justice, protection from harm, inclusion, and moral responsibility.
Solidarity plays an important role in response to pandemics, natural disasters, and humanitarian crises. It has both an intrinsic and instrumental value in global health. However, it can result in unintended consequences when not practiced properly. When the unintended consequences of acts of solidarity are perceived by the intended beneficiaries to be so unacceptable that they are spurned, such solidarity is objectionable. This paper introduces the concept of objectionable solidarity and illustrates its global bioethical implications using the example of COVID-19 vaccine donations. Objectionable solidarity raises bioethical concerns including avoidable mortality, erosion of trust in health systems, and unjust distribution of life-saving resources. The argument then traces the roots of objectionable solidarity to fractures in the ethics of global health solidarity, and discusses the triggers of objectionable solidarity. Finally, this paper employs examples from Afro-Caribbean approaches to COVID-19 vaccine solidarity—such as reciprocity, sacrificidality, noblesse oblige, cooperativity, and simultaneity—as bases on which guidelines for navigating the ethics of global health solidarity in pandemic settings can be built.
Solidarity plays an important role in response to pandemics, natural disasters, and humanitarian crises. It has both an intrinsic and instrumental value in global health. However, it can result in unintended consequences when not practiced properly. When the unintended consequences of acts of solidarity are perceived by the intended beneficiaries to be so unacceptable that they are spurned, such solidarity is objectionable. This paper introduces the concept of objectionable solidarity and illustrates its global bioethical implications using the example of COVID-19 vaccine donations. Objectionable solidarity raises bioethical concerns including avoidable mortality, erosion of trust in health systems, and unjust distribution of life-saving resources. The argument then traces the roots of objectionable solidarity to fractures in the ethics of global health solidarity, and discusses the triggers of objectionable solidarity. Finally, this paper employs examples from Afro-Caribbean approaches to COVID-19 vaccine solidarity-such as reciprocity, sacrificidality, noblesse oblige, cooperativity, and simultaneity-as bases on which guidelines for navigating the ethics of global health solidarity in pandemic settings can be built.
This paper examines the “expressivist objection” to physician-assisted dying (PAD) laws, which argues that limiting eligibility to terminal or incurable conditions expresses a discriminatory message devaluing such patients’ lives. It critiques three common responses—abolishing PAD, removing medical criteria, and consequentialist justification—as inadequate. Instead, the author proposes that legally protecting healthcare professionals’ conscientious objection can counterbalance this expressive harm. By accommodating conscientious objectors, the legal system actively affirms that the lives of incurably or terminally ill patients remain worthy of respect and preservation. This expressivist rationale grounds conscientious objection as a legal right rather than a mere permission, offering a key mechanism to address the moral residue generated by PAD legislation. Furthermore, this expressivist rationale addresses concerns about the reasonableness, genuineness, and professional ethics of conscientious objection. Finally, the paper provides a principled defence of conscience protections that preserves value pluralism without undermining access to PAD or abandoning the clinical foundations of PAD.
Maintaining best practice around surgical consent is a core competency, yet in caring for older patients, it can be particularly challenging to meet these standards. Our research question was: In the context of obtaining surgical consent for older people, what are the barriers to, and enablers of, best practice? A literature review was undertaken, using RAMESES (Realist And Meta-narrative Evidence Syntheses) methodology, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eight studies were identified by searching PubMed, Embase, Medline and CINAHL databases, supplemented by reference list searches. Four major themes with subthemes emerged: 1. Complexities: (i) Factors affecting decision-making capacity; (ii) Patient Comprehension; (iii) The doctor–patient relationship and barriers to autonomy; (iv) Ethical issues at stake; 2. Gaps between theory and practice: (i) Lack of proper documentation; (ii) Patient resistance resulting in coercion and restraint; (iii) Proper practice in the emergency context; 3. Reasons for gaps between theory and practice: (i) Lack of knowledge and training: physician misconceptions; (ii) Guesstimates of cognition don’t work; (4) Potential solutions: (i) Promoting patient autonomy; (ii) General communication strategies; (iii) Person-centred education step. Notwithstanding a limited yield, this review has identified several pitfalls and practical strategies for promoting human-rights and autonomy; avoiding coercion and restraint in this complex setting.
The decriminalization of surgical and medical abortion in many Australian jurisdictions has led to discussions about the systemic and moral barriers to accessing abortion services. This article reflects on Conscientious Objection (CO), as one of such barriers in abortion services in Australia. Two broad positions are identified in the moral disagreement between a patient's legal right to abortion and a doctor's right to conscientiously object to providing such service: (1) pro-conscientious protection and (2) anti-conscientious protection. While each of these positions motivates different courses of action that may independently count as right, a fundamental ethical challenge is resolving the disagreement in ways that both positions are jointly satisfiable. This article argues that (1) and (2) are prima facie flawed as they may perpetuate medical paternalism, psycho-social and moral distress, medical abandonment, moral standing diminution, and reproductive injustice, which considerably impact both patient and physician to varying degrees. This article suggests an Ethic of Solidarity (ES) as an important relational anthropological frame that inspires some compromise in the moral disagreement. When the virtues of solidarity, such as cooperation, sharing, and reciprocity, are applied to the dilemma between respecting a patient's right or doctor's professional conscience in abortion service encounters, inclinations toward interchangeable compromises emerge. This article concludes that an ES is worth taking seriously in the CO debate in Australia and beyond.
The rapid integration of artificial intelligence (AI) in ophthalmology has produced remarkable diagnostic accuracy while simultaneously raising significant ethical and epistemic concerns. This article argues that the prevailing AI paradigm fosters a form of data-fetishism: the tendency to treat datasets and algorithmic outputs as objective truth, privileging measurable metrics over the patient's lived experience and clinical context. Inspired by Marx's concept of commodity fetishism, the analysis demonstrates how this phenomenon produces "algorithmic substitution": a process through which the clinical encounter is converted from an ethically engaged encounter into a data-centric transaction, subordinating beneficence to statistical optimization. Four interconnected manifestations are examined: (1) dataset bias, where the marginalization of rare diseases and non-Western populations constitutes an epistemic injustice; (2) citation bias, which reinforces academic power structures; (3) the "covidization" of research, illustrating metric distortion; and (4) language hegemony, resulting in the epistemic erasure of regional medical knowledge. Clinical evidence reveals that these biases produce systematic errors in high-stakes domains such as ocular oncology and retinal surgery. The analysis concludes that data-fetishism enables a "moral deskilling" of ophthalmologists, redirecting professional fidelity from the suffering patient to the optimized dataset. Preserving the fiduciary essence of medicine requires a reorientation towards epistemic justice, emphasizing representativeness, ethical design, and the maintenance of the clinical gaze.
The question of when, if ever, healthcare professionals with conscientious objections should be accommodated by permitting them to refuse to provide medical interventions to which they morally object is a heated issue that has received significant attention in the medical ethics literature. While many professional medical associations have long held that such objections may be accommodated in a broad range of cases, a vocal and growing minority has been fervently arguing that the medical profession should cease accommodating conscientious objections and should rarely, if ever, permit clinicians to refrain from providing medical care merely because it conflicts with their conscience. One of the most popular arguments offered by non-accommodationists focuses on the claim that conscientious refusal is incompatible with healthcare professionals' fiduciary duty to put patients' interests ahead of their own. The aim of this paper is to show that, despite its initial plausibility, this argument is unable to withstand scrutiny. There is no fiduciary duty that is obviously incompatible with conscientious refusal that it is plausible to think healthcare practitioners actually have.
BACKGROUND:With prison populations expanding and aging, palliative care (PC) is an urgent concern. People in prison (PIP) face chronic illness, mental health conditions, and social vulnerabilities, creating ethical and psychosocial challenges to dignified end-of-life (EOL) care. OBJECTIVE:This scoping review mapped key ethical and psychosocial domains in the provision of PC in prisons. METHODS:PubMed, Web of Science, and ScienceDirect were searched using the strategy: Population-individuals in prison; Concept-ethical and/or psychosocial issues in PC; Context-PC provision in prisons across regions and healthcare models. Data were coded inductively, organized into ethical and psychosocial domains, and synthesized narratively. RESULTS:Sixteen studies were included, mainly conceptual analyses (n=10), most from North America (n=11). Ethical domains included structural neglect of PIP with life-limiting illness, barriers to compassionate release, compromised autonomy, denial of death in prison culture, and inadequacies in care quality and access. Psychosocial domains encompassed stigma, mistrust, isolation, existential suffering, and fractured social bonds. PIP-led hospice models offered companionship but raised tensions around labour, confidentiality, and the normalization of death in custody. CONCLUSION:Prison-based PC requires systemic reforms, staff training, family and advocacy involvement, and legal safeguards to ensure equitable, compassionate, and dignified EOL care.
