Abstract This editorial makes the distinction between the use of AI for editorial tasks and AI for authorship tasks and outlines requirements for authors in relation to each. AI use for editorial tasks should be acknowledged in Acknowledgements, except for its use for grammar checking and reference formatting. AI use for authorship tasks should be described in a Methods section. We commit to fair peer review for manuscripts that have such Methods sections. Other policy changes to manage the accelerated pace of manipulation of the publication process are also described. We caution authors about ways that AI may introduce errors and new content even when the author intends to limit the scope of its editing, translating, or grammar checking, and about ways that AI may mislead authors about what good academic prose looks like.
Abstract In rural and resource-constrained settings, surgeons often work within fragile health systems marked by delayed referrals, poor transport, limited specialist access and uneven infrastructure. Under such conditions, resilience, improvisation, low-cost adaptation and informal referral-building are often morally necessary forms of responsible care rather than ethical compromise. The ethical problem arises when these practices are celebrated in ways that conceal the structural failures that made them necessary. This essay argues that a coherent public health ethics of rural surgery must distinguish between bedside duties and system duties. At the bedside, surgeons remain obligated to provide the best available care within real constraints. At the system level, clinicians, institutions and policymakers must resist narratives that convert necessity into virtue and scarcity into acceptability. Romanticised resilience can normalise preventable inequity, displace institutional accountability and obscure patients’ claims to timely, safe and dignified care. Ethical rural practice therefore requires both adaptive clinical judgement and structural honesty.
The term 'deaths of despair' refers to suicide, drug overdoses, and alcohol-related mortality in the context of concern about rising mortality rates. This paper employs a philosophical distinction between despair and hopelessness, and their positive counterparts, hope and hopefulness, to examine how behavioral public policy can offer tools to reduce these deaths and what role autonomy plays in such contexts. The paper introduces a further distinction within hopelessness (desiderative and doxastic) each affecting autonomy in different ways, depending on whether desires, beliefs or both are compromised. The analysis considers autonomy from two perspectives: first, how it is diminished in the psychological and social contexts that give rise to deaths of despair; and second, how it may be further compromised by behavioral interventions that rely on paternalistic influence. By integrating these conceptual and ethical dimensions, the paper develops a framework for assessing when and how autonomy-sensitive behavioral interventions can be ethically justified in contexts marked by despair and hopelessness.
The concept of complicity has received increased interest in academic and popular venues to describe a range of moral phenomena including contributing to genocide, state violence, and systemic racism. However, a principle of non-complicity has generally not been included in lists of public health ethics principles. Complicity is a useful concept in the context of public health as can speak to wrongdoing in complex organizational and socioeconomic networks such as those promoting (or undermining) public health. In this paper, I argue that a principle of non-complicity complements typically used public health ethics principles. After describing common categories of public health ethics principles, I discuss the role of a principle of solidarity in providing a practical attitude toward addressing injustice and note limitations of this principle when applied to more global and universal contexts. I then describe two forms of complicity and how they can be used to illuminate the ethical dimensions of public health. I argue that a principle of non-complicity complements other public health ethics principles by providing motivation for addressing the shortcomings of our public health systems and providing direction on how to move forward.
The growing number of zoonotic diseases in the last few decades, caused by increasing human-nature interactions and the devastating impacts of global climate change on health, has compelled global stakeholders to start considering the need for a paradigm shift in global public health governance. In this paper, I show that although the One Health approach is one of the most recent global responses to the growing human-environmental health crises, indigenous people around the world have some of the earliest and enduring examples of the idea of One Health. I demonstrate this by examining the indigenous African notion of health as one of such examples. It is a wholistic and interconnected outlook, where health is perceived as moral, spiritual, ecologic and cosmic harmony. When the health of part of this integrated universe is threatened, the entire universe is in peril. According to this African conception of health, no individual can be considered healthy if a member of the community is sick. There is solidarity not only between created beings, but also between the natural and the supernatural world. I show that some ideas from the African relational view of health may contribute insights to the global conversation on One Health.
