The primary objective of the study was to analyse the correlations between belief in and acceptance of vaccine-related conspiracy theories and prevailing cultural models. The authors emphasise that not only right-wing populism and fundamentalist beliefs, but also postmodern relativism, may contribute to the rejection of established medical knowledge and practices. Drawing on a survey conducted among a representative sample of 1000 members of the Polish population using random-quota sampling, the authors offer an analysis at the level of preferred models of knowledge and the epistemological conditions that contribute to the rejection of contemporary medical knowledge on vaccination in the aftermath of the COVID-19 pandemic. The article is inspired by the theoretical concepts of Ernest Gellner. This cultural and epistemological analysis of knowledge models that support the rise of vaccine hesitancy across different societies may contribute to a better understanding of the anti-vaccination movement and cultural trends that fuel belief in conspiracy theories and medical populism. The authors argue that the principles of Enlightenment rationalism – grounded in knowledge verified through transparent and testable procedures – provide essential cognitive support in countering vaccine-related myths, rumours, and conspiracy theories.
People’s supportive attitudes towards the publicly funded health system are crucial for ensuring the system’s sustainability through crises and maintaining its core functions of funding and providing health services for all. In the literature, this supportive attitude is considered a form of health sector solidarity. Existing explanations for health sector solidarity focus on individuals’ feedback to the health system—such as satisfaction and performance evaluation—but pay scant attention to the moral judgements underlying this solidaristic attitude. This study aims to investigate the moral foundations of health sector solidarity in Taiwan. Using the Taiwan Society Political and Moral Values Survey 2025 data, the study examines the relationships between health sector solidarity and moral foundations. The findings indicate that, after controlling for respondents’ socio-demographic characteristics and health system-related attitudes, solidarity is positively associated with beliefs in mutual assistance, reciprocity, the human right to health, and self-interest, and negatively associated with meritocracy. National sentiment is not significantly associated with health sector solidarity. By including the moral foundations, this study provides a more comprehensive examination of the factors influencing health sector solidarity in Taiwan and informs future health reform agendas.
Open data has become central to biomedical research and public health, but health information is uniquely sensitive and difficult to share responsibly. In this narrative review, open data is considered as a spectrum of health-data sharing arrangements, ranging from public aggregate datasets to controlled-access repositories, federated analysis, and synthetic data. This narrative review synthesizes the scientific and societal rationale for greater openness with the ethical, legal, and governance constraints that shape what “open” can realistically mean in healthcare. We examine how data sharing supports reproducibility, machine learning, and more efficient research, while also enabling public health surveillance and learning health systems. Against these benefits, we analyze privacy and re-identification risks, consent challenges in large-scale secondary use, inequities including data colonialism, and tensions introduced by commercialization. We integrate lessons from prominent case examples spanning pandemic data sharing, genomic initiatives, population registries, patient-led rare disease infrastructures, and regional data spaces. Across these domains, experience suggests that durable progress depends less on unrestricted openness than on calibrated access, privacy-preserving architectures, clear accountability, and sustained public engagement. We conclude by proposing a pragmatic ethical orientation for healthcare open data: treat openness as a spectrum of controlled sharing arrangements, embed equity and reciprocity into governance, and institutionalize trust-building measures that can persist beyond emergencies and political cycles.
Conflicts arise when surrogates request life-sustaining treatments that clinicians consider medically futile. This article proposes that early presumptive medical mediation with opt-out provisions should become the default initial offer for resolving such disputes. Grounded in Rawlsian procedural justice and the virtue of epistemic humility, and informed by limited and indirect evidence from healthcare mediation and ICU communication-facilitation programs, this approach offers a fair-process dialogue that can support patient-centered deliberation and clinician integrity when embedded within appropriate legal and ethical safeguards. Mediation offers four procedural advantages: (a) protected and appropriately inclusive voice, (b) confidential caucus, (c) interest-based framing, and (d) outcome ownership. Unlike arbitration or ethics committee determinations, mediation is structured around voluntary participation, mediator neutrality and confidentiality. It does not impose a binding outcome or reallocate legal decision-making authority. These procedural features distinguish mediation from adjudicative or advisory processes, although their comparative effectiveness is context-dependent. Statutory “safe-harbor” models, such as the Texas Advance Directives Act, illustrate how structured dispute-resolution frameworks can be embedded in policy, although they do not themselves constitute mediation. Embedding an early, structured offer of mediation in end-of-life policy may reduce escalation and strengthen the procedural legitimacy and acceptability of decision-making when voluntariness and appropriate clinical, ethical and legal safeguards are maintained. However, it cannot guarantee agreement, shorter ICU stays, reduced litigation, or substantively correct ethical outcomes.
As the use of digital information technologies has grown and transformed health care practices and ecologies, concerns have been raised about the implications for health care relationships. But it is no simple matter to pin down what makes health care relationships good and valuable, nor to assess whether and how digitalisation changes this. ‘Relationship goods’ such as care, compassion and respect are conceptually and practically complex. Longstanding models based on assumptions of dyadic relationships between individual health care practitioners and patients are no longer fully fit for purpose. This paper makes a case for re-thinking health care relationships to reflect the ongoing shift to digital health care ecologies. It outlines some of the key questions and considerations that will need to be addressed to support more rigorous evaluations of the implications of digital technologies and to better guide future design and health care improvement work. It illustrates some of the resources that exist within contemporary philosophy and ethics to support this agenda and calls for collaborative interdisciplinary working to investigate and help preserve the value of health care relationships through ongoing change.
