Purpose This study aims to examine the polarised discourse surrounding selective serotonin reuptake inhibitor (SSRI) use during pregnancy and to propose a human rights-based and autonomy-focused approach grounded in reproductive justice and shared decision-making. Design/methodology/approach This viewpoint presents a rights-based ethical reflection informed by a narrative synthesis of current evidence, including the US Food and Drug Administration’s 2025 expert panel on SSRIs during pregnancy, and the literature from perinatal psychiatry, medical ethics, human rights and public health communication. The paper explores how scientific uncertainty, risk communication and social context influence treatment decisions during pregnancy. Findings The debate surrounding SSRI use during pregnancy is frequently framed as a binary choice between protecting foetal well-being and treating maternal mental health conditions. Such polarised narratives risk oversimplifying a complex evidence base and may undermine informed decision-making. Current evidence suggests that both untreated perinatal mental health conditions and pharmacological treatment involve potential risks and uncertainties. A rights-based approach requires balanced communication, recognition of relational autonomy, attention to structural inequalities and meaningful participation of pregnant women in decisions affecting their health and well-being. Originality/value Existing discussions have largely focused on pharmacological safety, maternal mental health outcomes and foetal risks. Comparatively less attention has been paid to how human rights principles, including autonomy, participation, informed consent and reproductive justice, should guide decision-making under conditions of scientific uncertainty. This paper addresses that gap by reframing SSRI decision-making during pregnancy through the lenses of autonomy, participation, informed consent, reproductive justice and rights-based mental healthcare. It advocates a shift from paternalistic and polarised approaches towards more collaborative, person-centred and ethically grounded care.
PurposeThis paper examines the perception of people involved in the management of patients' data towards the security and privacy framework in Indian hospitals. The paper aims to identify the major weaknesses in the data management system and their implications for data administrators, government agencies and regulators.Design/methodology/approachThe authors use a survey method to examine the perceived data security and privacy by assessing Vulnerabilities, Mitigation Strategies, Incident Response and Compliance in the data management systems of 132 hospitals in India with 496 respondents deploying an SEM Model.FindingsResults indicate that trust among patients and other healthcare partners is disintegrating. The authors also find a dire need for training data management staff, replacing technological infrastructure, properly implementing regulations and synchronising knowledge of data breaches between government agencies and data administrators.Originality/valueThis paper is probably the first attempt at researching this area in the Indian context. This research has important managerial implications for Indian hospitals that need to transform their operational models and invest in digital infrastructure upgrades. This research also has significant policy implications for the Health Ministry and other regulators. Government authorities can evolve a portal for continuous patient feedback and grievances in a data security context. In addition, public awareness programs on data security aspects may be conducted regularly for society's benefit.
PurposeThe purpose of this paper is to see whether empowered women have a greater likelihood of choosing contraceptives compared to "not empowered women." It is also interesting to see whether multiple dimensions of women's empowerment have a greater association with the "modern method" or "traditional method" of contraception.Design/methodology/approachThis paper uses data from the fifth round of the National Family Health Survey (NFHS-5) to test this association. This paper has used a subsample of 81,779 married women aged 15-49. The outcome variable is "current use of contraceptives by method type." This variable is categorical. There are three categories: modern method of contraception, traditional method of contraception and no use of contraception. The treatment variables are four indicators of women's empowerment. This paper has included some demographic and socioeconomic factors as control variables. This paper has used the "multinomial logit model" to find the association among multiple dimensions of women's empowerment and current use of contraceptives by method type.FindingsAfter controlling for demographic and socioeconomic factors, the author observes that women's empowerment has a positive association with the use of contraceptives. However, women's empowerment has a more notable impact on traditional methods of contraception than on modern methods of contraception. This differential impact of women's empowerment might be due to a husband's perception that contraceptive use makes women promiscuous. Female employment, living children and husband's education have a significant positive association with modern contraceptive use.Research limitations/implicationsA key limitation of this paper is that it is a cross-sectional study. This paper can say whether there is any association between empowerment indicators and the choice of the method of contraception. If the study is longitudinal, then one can say whether women's empowerment is the reason behind the use of contraceptives.Originality/valueAmong several studies regarding the impact of women's empowerment on the use of contraceptives, to the best of the author's knowledge, this paper is unique because it has studied the impact of both attitudinal and behavioral scales of empowerment on the current use of contraceptives by method type.
PurposeThis paper aims to address an urgent and politically charged issue: the quantification of women sterilized without informed consent during Peru's Fujimori regime. While prior narratives and public reports have drawn attention to this issue, this research contributes a novel empirical analysis that solidifies the extent of these human rights abuses.Design/methodology/approachThis study uses data from the 2000 Demographic and Health Surveys (ENDES/DHS) and Ministry of Health records to document the extent of the lack of information provided to sterilized women. It consists first of a descriptive approach that links the variable on lack of information and the adopted contraceptive method. Then the study performs a comprehensive estimate of the impact of denied information on the probability that a woman be sterilized. This research also estimates the causal effects of lack of information on the probability of regret about the sterilization. To ensure unbiasedness and robustness of results, several empirical strategies are implemented, all of which deliver very stable coefficients.FindingsThis study not only corroborates testimonies of coerced sterilizations but also challenges prevailing denials that seek to minimize the severity of these violations. The findings reveal a profound intersection of health policy, human rights and gender-based discrimination, with implications for policymakers and scholars who examine the intersections of public health, law and political accountability. This study finds that of the 336,000 sterilizations performed between 1993 and 2000, approximately 220,000 women were deprived of essential information regarding alternative contraceptive methods, the risks of sterilization and its permanent consequences. In this revised version, it is also found that lack of informed consent causally accounts for 130,000 cases. Moreover, 26,000 women were not informed that the procedure would permanently prevent future pregnancies.Research limitations/implicationsA limitation of this research, shared with any quantitative research that uses survey data, is that the exactness of results diminishes substantially for a more granular analysis. Future research may be able to remedy this limitation.Practical implicationsThese findings offer a stark rebuttal to revisionist narratives that frame coerced sterilizations as isolated incidents, underscoring the widespread nature of these human rights violations. A quantitative well-documented account of the massiveness of sterilization performed without informing properly to women would create awareness of this issue that will increase the probability of justice being made, reparations being acknowledged and that cases like this do not happen anymore.Social implicationsThese underscore the widespread nature of these human rights violations. This study also shows how the poorer women of Peru, mostly Indigenous women, were subject to being sterilized without proper information.Originality/valueSo far, nobody has attempted to perform an estimation of sterilizations performed without informed consent in Peru. This study proposes a rigorous method based on data to overcome the difficulties for such estimation. It also complements the descriptive documentation of the massiveness of sterilizations with an estimation of causal effects from denying information about the consequences of sterilization on the probability of being sterilized. The main contribution is to complement the existing qualitative and case-studies documentation with a quantitative account of the magnitude of sterilizations without informed consent.
Purpose The misuse of restrictive interventions including restraint, seclusion and pharmacological restraint is an increasing source of concern. This has led to calls to address the issue based on the principles of human rights. The purpose of this paper is to reflect on previously unaddressed aspects of adopting such an approach. Design/methodology/approach This paper uses frame analysis to critique what it suggests is a dominant uni dimensional frame of human rights i.e. one that excludes consideration of the human rights of the health and social care workforce. Findings It finds that the uni-dimensional frame is potentially flawed and should be rejected in favor of a binary perspective that recognises that preventing the misuse of restrictive interventions requires the authors to promote the human dignity of those in receipt and those involved in the provision of services. Research limitations/implications Such binary approaches have however not yet been empirically evaluated and further research is needed. Practical implications Reducing the misuse of restrictive interventions invariably though requires “whole organisation” strategies. In designing these initiatives services should include an explicit focus on the human dignity of staff. Social implications This focus should be reflected in policy initiatives whether at a local, regional or national level. Originality/value To date it appears that advocacy of uni dimensional human rights based approaches to restrictive intervention reduction has been uncritically accepted. This paper addresses that omission and proposes an alternative binary approach which may offer a greater likelihood of successfully addressing the root causes of restrictive intervention misuse.
