In research and clinical practice, the words chosen to describe others matter, particularly regarding race and ethnicity. Some terminologies are particularly problematic and should be avoided, given their tendency to distort cohorts of individuals based on presupposed common attributes and demographic characteristics. Racial taxonomy may unintentionally give rise to pejorative and potentially unsettling connotations. Hence, outdated racialised designations should be superseded by ethically and scientifically meaningful alternatives. The term Caucasian, as demonstrated in this manuscript, has persisted as a frequent terminology in Western biomedical parlance when referring to white individuals. The use of the term Caucasian represents a relic of an outdated and prejudiced racial classification system. In particular, the persistence of this terminology in the Australian healthcare setting is in disagreement with contemporary scientific and worldview values. Although the use of Caucasian as a descriptor has been challenged, given its inherent taxonomic and methodological flaws, several professional associations continue to include Caucasian as an acceptable category in racial classification systems, which suggests this time-worn term remains in wide use. It is likely, therefore, that the persisting use of Caucasian will continue to generate unreliable information and contribute to a misinterpretation of Australian populational composition. To the authors’ knowledge, the persistent use of Caucasian as a demographic descriptor has never been questioned in the Australian scientific literature. It is hoped that the argument presented herein will prompt further debate and development regarding this critical issue.
As more countries explore uterine transplant as a potential solution to absolute uterine factor infertility there is an urgent need to develop appropriate organ allocation methods that align with community expectations. The first live birth in Australia using a donated uterus occurred in December 2023 as part of a clinical trial at the Royal Hospital for Women in Sydney. For this research paper, an online survey was conducted in August 2024 on a sample of Australian adults (n = 395) regarding their attitudes toward uterine transplant within the context of the Australian healthcare system and Medicare. Survey questions asked participants to consider who they thought should be eligible to receive or donate a uterus for transplant, how potential recipients should be prioritised, who should pay, and what reasons, if any, they considered ethically acceptable for providing this novel transplant type. Organ transplantation programs rely on community awareness and support, so securing a social licence before expanding uterine transplant services is essential to ensure this new treatment does not negatively impact other forms of organ donation. The results of this study have policy implications for if and how uterine transplant should be integrated in standard fertility care in Australia, and globally.
Surrogacy and uterus transplantation (UTx) are current forms of assisted gestation. Support for UTx is often grounded on the basis that it would ethically and legally mitigate the moral issues associated with surrogacy. In this article, I problematize this narrative by highlighting the perspective of third parties to assisted gestation through the topics of incentivization and compensation. I demonstrate that the ethical, legal, and social idiosyncrasies associated with each technique make it the case that UTx does not easily resolve the shortcomings of surrogacy – and vice versa.
There is a shortage of organs for transplantation resulting in long waiting lists, and many die while waiting for a new organ. Different policies are discussed for solving this problem, but the most effective, namely the conscription of cadaveric organs, the routine taking of organs from dead bodies, is considered too controversial and is therefore not implemented anywhere.I discuss the reasons for and against conscription; the former are mainly based on utilitarian arguments, while the latter are mainly based on the interests and rights of the deceased and his family. (He, his, or him, is understood to mean he/him/his or she/her/hers throughout the article.) .This article investigates whether the deceased has any interests and rights. I argue that dead bodies are mere things and thus without interests or rights. I also discuss whether the interests of the family should override the needs of patients who are on waiting lists for organs.Using arguments based on Epicurean philosophy, and supported by contemporary scholars, I conclude that dead bodies do not have interests and rights and that the possible interests and rights of the dead’s family cannot be more important than saving the lives of the people on waiting lists for organs.Thus, I argue that conscription of cadaveric organs for transplantation can be defended and should be implemented as a normal hospital practice.
Bayanihan, commonly understood as the spirit of cooperation with the kapwa (shared identity), is often attributed as a distinctly Filipino trait that motivates altruistic and ethical actions. Despite this popular image, a lacuna exists in understanding how this concept applies to foreign migrants residing in the Philippines. In this paper, we aim to explore the identified gap and, in turn, propose a normative framework for migration health ethics grounded in the Filipino philosophical concepts of bayanihan and kapwa, arguing that these concepts offer an interesting alternative to the dominant theories and policies on migration. To accomplish this aim, we begin with a discussion of the conceptual foundation of migration health ethics. Afterwards, we situate bayanihan and kapwa, highlighting their ethical significance as well as their limitations and possible misuses. Finally, we propose how theseFilipino concepts can guide the development of an equitable and inclusive framework for migration health ethics in the Philippines.
The debate on euthanasia and medically assisted suicide remains a complex issue, full of ethical, moral and legal implications, which has aroused strong emotions and conflicting opinions both in Italy and around the world. In Italy, the legal context surrounding euthanasia and medically assisted suicide is still characterized by an absence of specific rules regulating these practices. This has led to a situation in which the discussion on the end of life remains open and the practice of euthanasia remains illegal as the only interruption of life-sustaining treatments is allowed at present in accordance with the provisions of Law 219/17. Similarly, there is no specific rule concerning medically assisted suicide but only conditions identified by the case-law that make this practice not punishable in particular cases. In this delicate context, the role of the forensic physician is of paramount importance to ensure that these practices are carried out in a legal manner that respects the dignity of the patient. Starting from a description of the regulatory context of reference, a revision of news media cases that have been characterized by having added, from time to time, a piece to compose the current legal context, was conducted tracing analogies and similarities.
This paper challenges the typical function of narrative in the medical humanities to advocate for a medical posthumanities: an approach that destabilizes the centrality of "the human" and instead embraces patient narratives that are embodied, fragmented, and provisional. To make this claim, we first challenge the stability of the "humanity" described in the "medical humanities" and reiterated in the genre that we call "the medical romance." In this genre, illness and suffering destabilize a sense of identity and coherence, which is then restored through introspection and interpretation of the patient narrative. To challenge this genre, we turn to surface reading, a literary studies technique that sees traditional interpretation as too hurriedly foreclosing on meaning. Through a close reading of Franz Kafka's The Trial and Henrik Ibsen's Hedda Gabler, we demonstrate both what surface reading looks like and also how it embraces generic and interpretive instability. Finally, we focus this approach to narrative on physician-assisted suicide (PAS), particularly attending to PAS and disability, to argue that both medical romance and its entailed traditional narrative interpretation overvalue "the human" as an agential individual seeking a "good death." This at once affirms the tendency to encourage the allegedly meaningful death of disabled people by PAS, and also excludes from narrative focus the structural and environmental sources of suffering. The medical posthumanities, in its attention to embodiment, networks, environment, and the decentralizing of individual agents, would better make room for patient narratives that value the messiness and interconnectedness of lived experience.
After more than fifty years of debate on the definition of death, there remains no consensus among bioethicists. This article identifies the conflicting interests represented by various groups within the bioethics community as the primary cause of this stalemate. It argues that the impasse can be overcome if bioethicists recognize these conflicting interests as the fundamental reason for their disagreements, rather than viewing the dispute as primarily concerning the scientifically adequate concept of death. This article proposes a strategy on how to reach a consensus. The core idea in this regard is that the definition of death, in a socially important sense, needs to protect the interests of individual members of society.
Researchers developing artificial amnion and placenta technology (AAPT) regard this endeavor as one to enhance outcomes in neonatal intensive care units (NICU), by reducing mortality and morbidity for extremely premature neonates. While other applications can be imagined and have been the topic of ethical debate, there is discontent about bioethical considerations of potential AAPT applications beyond NICU praxis. Dismissed as 'speculative', the latter allegedly cloud 'real' ethical work necessary for clinical translation. This trope requires ethical attention, since it goes to the heart of bioethical praxis as an effort of studying emerging technologies like AAPT, and as a critical enterprise tethering ethical contemplation to empirics and uncovering value-ladenness of empirical 'facts'. We explore different functions of speculation in ethics, after which we examine the main criticisms against the purported speculative implementation of AAPT. We then address how defining a practice as speculative reveals more about research priorities and biases, than about some quality of the practice. Labeling scenarios as 'speculative' seems to function as an argument in and of itself, rather than that an argument is provided for labeling certain scenarios as speculative, and why this matters. More: the 'speculation argument' can be extended to the translational aims of AAPT, its potential risks, and the assumed 'benefits' in terms of mortality and morbidity. Projections about 'morbidity' and 'quality of life' that do not start from insights and experiences of members of the disability community are precisely the type of speculation that should be questioned from a critical ethics perspective.
This study aimed to verify the effect of financial incentives and the feeling of guilt in the formation of the intention to donate organs of relatives' post-mortem. The method used was a single factor experiment, with the manipulation of financial compensations under three conditions (low value, medium value, high value) and altruism as a control group. In a convenience sample, 152 Brazilian individuals participated in the study. The results reveal that the greater the financial incentives, the lower the intention to donate, and that the greater the amount of money, the greater the feeling of guilt and the lower the intention to donate. This relationship between guilt and the formation of intent to donate contributes to a better understanding of the role of subjective norms in the formation of intent to donate organs, shedding light on the understanding of social behavior that involves post-mortem organ donation.
The growing integration of the medical humanities in medical school curricula highlights its importance in the development of culturally safe, patient-centred clinicians. Internationally, medical schools attempt to increase student engagement through course electives, different modes of assessment and diverse content delivery. At the University of Melbourne, the Professional Practice program aims to provide an easy, engaging way of exposing students to the medical humanities, including reflective practice, collaborative practice, leadership, advocacy, professional identity formation, medical ethics and law. However, students' perceptions of the medical humanities may prevent desired outcomes from being reached. We discuss the student experience of the Professional Practice curriculum through a collaboration between a student, tutor and course designers focusing on student engagement and perspectives of the program. Overall, students felt uncomfortable with the flexibility and ambiguity of the medical humanities when compared to the rigidity of biomedical knowledge. Additionally, modes of assessment typically used in the humanities such as reflective writing were found to be unpopular. Students' involvement in the co-facilitation of classes helped develop communication skills and leadership but overall participation was still dependent on individual factors. Ultimately, the medical school and student body must work together to develop a medical humanities curriculum that is both complementary and viewed as of equal importance to the clinical curriculum.
There has been a shift of dynamic in the relationship between technology and healthcare, with technological advancements progressively driving change in the delivery of care and, at times, causing disruption to the traditional doctor/patient partnership. This shift is significant in the context of medical devices. Increasingly complex devices are being introduced which require a level of technical expertise outside of the scope of the traditional training of doctors, with this knowledge gap progressively filled by medical device representatives (MDRs), a role that began as devoted to sales and has now expanded to that of adviser and trainer. This change in role represents a blurring of lines between sales and support and has potentially flourished within a regulatory gap. This paper addresses the challenge of the evolving relationship between MDRs, surgeons and patients and is based on the findings of a broader project "Support or Sales? Medical device representatives in Australian hospitals". It provides an overview of the outcomes of a series of interviews with stakeholders highlighting their perceptions and experiences at this point of intersection between care and sales. It then examines the existing regulatory framework and considers whether there is a real or perceived regulatory gap. This analysis of current regulatory measures in areas such as hospital safety, privacy and professional regulation and conflicts of interests, leads to a conclusion that the evolving relationship between MDRs and surgeons has not taken place in a regulatory vacuum and sufficient frameworks are in place to protect the public. However, they rely heavily on translation into local policies and concurrent adaptations to best practice behaviour which does appear to be lagging, resulting in insufficient transparency and recognition of emerging contexts requiring novel applications. This lag could threaten patient safety and patient trust in the healthcare system.
The medical humanities developed in the second half of the 20th century in response to challenges of mechanisation and dehumanisation in medicine. Humanities disciplines like literature and art and social sciences like anthropology and sociology served to ameliorate reductionistic tendencies in medicine and ensured that medical trainees developed a deeper understanding of patient experiences and perspectives. The medical humanities bequeathed to medicine a capacity for self-critique and highlighted ways in which medicine could provide more humane care to patients. One challenge, however, that remains inadequately addressed is the task of providing a solid humanistic formation to physician trainees who are preparing to care for patients at the end-of-life. This essay thus considers the role of medical humanities in the formation of physician trainees who will care for dying patients. We seek to identify specific ways in which we improve the humanistic formation of doctors so as to prepare them to care for dying patients. We close with recommendations for how to adapt medical education and training so as to include a more robust immersion in medical humanities content focused on death and dying.
While on the surface the rapid adoption of generative artificial intelligence (AI) in healthcare signals a new technological innovation that may sideline the social sciences, arts, and literature comprising the medical humanities, we argue that one way to understand the applications of AI based on large language models (LLM) in healthcare is as a deeply narrative project. LLM-based AI endorses narrative and humanistic value insofar as it is trained on vast amounts of narrative data as inputs and generates outputs in narrative formats. We contend that the medical humanities, rather than being replaced by AI in healthcare, are all the more essential to understand the practical and ethical opportunities and constraints for responsible use and integration of such tools. By analyzing two case studies of generative AI in healthcare reported in literature, we show that narrative medicine and the medical humanities provide crucial theoretical frameworks and disciplinary skills to assess, integrate, and critique the roles and impacts of such technologies in healthcare. Rather than offsetting narrative practice via AI, responsible use of LLM-based AI in healthcare requires attention to the functions of narrative in medicine and the importance of the medical humanities.
This article illustrates the contribution of Chinese philosophy to the field of medical humanities by focussing on the ideas and conduct of Confucius. Drawing on a Chinese philosophical classic, the Analects (Lunyu), this study proposes a Confucian reinterpretation of Beauchamp and Childress' principle of respect for autonomy in medical ethics. The paper begins by critiquing Beauchamp and Childress' three conditions of autonomous action, namely intentionality, understanding, and the absence of controlling influences that determine one's action. It is contended that the three conditions over-emphasise rationality and overlook the role of emotions and morality in autonomy. The second part of the article proposes a Confucian reformulation of the three conditions that is derived from the concepts of xin (heart-mind) and li (normative behaviour). The modified conditions are moral intentionality, the integration of understanding and emotions, and the absence of controlling influences that determine one's action and underlying values, beliefs, attitudes, feelings and predispositions. From a Confucian perspective, Beauchamp and Childress' positive obligation for the principle of respect for autonomy requires medical professionals to render empathetic treatment towards patients. By challenging and reconstructing major theories and assumptions in medical ethics, this paper demonstrates the saliency of non-Western philosophical traditions in medical humanities.
The aim of this article is to complicate and rethink histories of non-Western responses to vaccination, as well as to see how a historical perspective may contribute to contemporary discussions of vaccines within the medical humanities. This is done through a case study approach. The focus of this article is a collection of essays written by a Bengali prophet-astrologer and published during the plague pandemic in Calcutta, British India, at the turn of the twentieth century (1899). While one essay in the collection was critical of the plague vaccine, another essay, in a later section of the same collection, celebrated the vaccine and its developer Waldemar M. Haffkine. The first part of the article situates the context of the text's production, as well as the background of the author. In the second part, it analyses the reasons why the plague vaccine was criticised. In the third part, it looks at how the author celebrated the plague vaccine in a later section of the collection. In the fourth section, it attempts to answer why the astrologer changed his view on vaccination. Finally, in the conclusion, it discusses how this case study intervenes historiographically, and how certain themes raised by the source persist today, reiterating the importance of a historical perspective.
This study examines the declining fertility rates in East Asian Confucian societies, focusing on the unique childrearing practices and how future advancements in human enhancement and reprogenetic technologies may further accelerate the demographic decline. The focus is on the obsession with “child perfectionism” driven by the pursuit of academic credentialism and hypercompetitive social norms. This phenomenon has roots in the historical imperial examinations of China and has evolved into modern college entrance exams. Recent growth in knowledge-based and technology-driven economies in East Asia has further fueled this trend, leading to the widespread practice of “tiger parenting” whereby parents push their children into the competitive educational system at an early age, often paying high fees for private tuition. Such intense pressure discourages many families from having more children, with some couples choosing not to have any children at all. The development of cognitive-enhancing brain chips and reprogenetic technology platforms for consumer eugenics, such as germline genome editing and polygenic embryo screening, may further increase financial strain on parents, potentially accelerating demographic decline. The term “Confugenics” is thus proposed to describe the intersection of these new eugenics and enhancement technologies with the Confucian emphasis on academic success, which may worsen the demographic crisis.
Medical humanities teaching in UK medical schools has lacked cohesion, having developed opportunistically in different locations. Cohesion is necessary to develop an identifiable community of practice, but within that community there can be multiple readings of what 'medical humanities' are and how they may develop. This article details discussions held by medical humanities scholars teaching in UK medical schools at a workshop in January 2025 at the University of Oxford covering five key areas: the role of humanities scholars in medical schools, patients as partners in medical education, core curriculum teaching, intercalated teaching, and assessment. Our discussion highlights opportunities and challenges facing humanities teaching in UK medical schools today and calls for the creation of a community of medical humanities scholars working in UK medical education embracing diversity of opinion and practices. The article is specifically written as a synopsis of a brainstorming symposium.
