Teaching bioethics contributes to promoting sound clinical decisions, but a research gap persists in Jordan regarding the ethical challenges facing physicians and their training requirements. This cross-sectional online survey assessed bioethics education, ethical awareness, perceived competence, and ethical practices among physicians practicing in Jordan. An anonymous questionnaire was distributed using convenience sampling through social media, professional networks, and medical associations. A total of 559 physicians participated. Most respondents were male (59.4%), aged 26-30 years (47.8%), and medical graduates from Jordan (83.5%). Although 64.2% reported at least 3 credit hours of ethics education, only 45.3% reported awareness of the four core bioethical principles. Most participants reported being able to identify ethical issues (83.5%) and to find answers to ethical dilemmas at least sometimes (84.4%). Ethical challenges were most often reported in relation to traditions and values (57.8%), law (53.1%), religion (52.6%), finance (51.7%), and conflict of interest (50.1%). Participants expressed strong interest in additional training, particularly treatment refusal, informed consent, diagnosis/prognosis communication, and end-of-life care. Findings suggest a need for practice-oriented, culturally grounded, and continuing bioethics education that links foundational principles to common clinical dilemmas. Education should develop case-based reasoning, reflective clinical judgment, and communication skills rather than terminology recognition alone.
The Biomedical Ethics and Regulatory Capacity Building for Portuguese Speaking African Countries (BERC-Luso) Project aimed to strengthen biomedical ethics and regulatory capacity in Lusophone African Countries. At the legislative level, it promoted the alignment of national laws with international best practices for biomedical research. At the institutional level, it promoted the establishment and strengthening of National Regulatory Authorities (NRA) and National Ethics Committees (NECs). This project also included professional training to enhance national expertise; however, this article focused primarily on the legislative and institutional developments achieved in São Tomé and Príncipe. It examines how capacity building translated into national regulatory reform. At the project's onset, São Tomé and Príncipe had minimal legislative and institutional frameworks and no specific authorities or legislation in the field. Despite these shortcomings, political commitment and stakeholder engagement enabled major developments. The country established an NEC for scientific research, competent in clinical research oversight and advanced the legal and institutional proposal for an NRA, setting key building blocks for future clinical trials. These advancements underline the transformative potential of capacity-building programs in resource-limited settings. This experience may serve as a model for similar initiatives in countries seeking to strengthen ethical and regulatory frameworks for biomedical research.
This paper explores what Confucius might say about the use of generative AI-based digital doppelgängers in healthcare for patients who are newly dead, dying, or comatose. We focus on the use of these technologies to support patients’ family members, loved ones, and surrogate decision-makers. Since Confucian approaches are largely missing from bioethics discussions of AI-based digital doppelgängers and patient preference predictors, this paper helps to fill an important gap. Section I introduces three cases involving digital doppelgängers representing people who are newly dead, dying, or comatose. Section II considers a Confucian response to the three cases. Section III applies Confucian values to a further situation, where the digital doppelgänger for a comatose patient functions as a patient preference predictor helping with a surrogate decision for a comatose patient. Section IV sets forth ethical benchmarks for using digital doppelgängers in healthcare. Section V recommends proceeding with caution and highlights the importance of further understanding the benefits and risks of using these tools in diverse cultural contexts.
On 20 May 2025, the World Health Organization (WHO) adopted the Pandemic Agreement at the World Health Assembly in Geneva. After nearly three years of negotiations and after failing to adopt it in 2024, this is a decisive step towards more combined efforts to address future pandemics. The final text of the treaty highlights the need for equitable access to pandemic-related health products and aims to improve the ability of international health regulators to guide countries during future pandemics. There is hope that by learning from mistakes made during the COVID-19 pandemic, the Agreement can be used to address global inequities and make globally equitable resource sharing the norm, preventing harmful practices, such as vaccine hoarding and barriers to data sharing. However, while the current Pandemic Agreement puts equitable access to surveillance, therapeutics, vaccines, and other pandemic-related products at the forefront, many important questions are yet to be answered. The authors of this paper draw attention to ethics preparedness efforts. The piece considers the importance of building the necessary infrastructure for the provision of ethical advice on health-related matters as part of the implementation phases of the WHO Pandemic Agreement to ensure that we learn from the mistakes made during the COVID-19 pandemic.
The ability to predict the risk of severe mental disorders holds considerable promise for individuals at risk, potentially enabling prevention and early intervention. Although the clinical application of such predictive models in child and adolescent psychiatry remains a future prospect, it is essential to consider their social and ethical implications that their use may entail. This study explores child and adolescent psychiatrists' views on these issues through a cross-sectional online survey distributed to members of the European Society for Child and Adolescent Psychiatry. Of the 81 respondents, the majority identified the most significant benefits of using prediction tools as enabling earlier intervention by healthcare professionals (81.5%), improving the quality of care (77.8%), and helping families enhance their resilience (63%). Participants also expressed concern about potential harms, particularly violations of privacy (74.1%), discrimination (92.6%), and the lack of explainability in Artificial Intelligence algorithms (74.1%). While most participants recognise potential medical benefits in the clinical use of predictive tools, numerous concerns must be addressed before such technologies can be considered viable. These include unresolved ethical challenges, such as risks related to privacy, potential of stigmatisation and discrimination, and algorithmic opacity, as well as limitations of healthcare systems.
