Preparing students to participate in scholarly bioethics debate is a central challenge in medical ethics education. Beyond understanding ethical theories and methods of analysis, students must learn to critically engage with ongoing debates, articulate and defend arguments in dialogue with other scholars, and navigate normative disagreement in respectful and constructive ways. While existing pedagogical approaches, including flipped classroom models, support active learning, they often remain confined to classroom settings and teacher–student dynamics. In this article, we analyse the pedagogical design and educational aims of the Oxford–Amsterdam Winter School in Bioethics, a collaborative programme that has been running annually for over a decade. The Winter School is structured as a conference-based learning environment in which Dutch graduate students pursuing a Master’s degree in Bioethics and Medicine or another health-related programme, and more recently undergraduate medical students from Augsburg, Germany, present critical analyses of published bioethics papers. Students present their work to an audience that includes the authors of the original papers as well as fellow students and scholars, enabling direct engagement with ongoing scholarly debate. The Winter School takes place at the Ethox Centre of the University of Oxford. We argue that this conference-based format provides a distinctive pedagogical model that treats students as emerging scholarly interlocutors rather than solely as learners acquiring new skills. In this sense, the Winter School functions as a liminal educational space between classroom teaching and participation in academic conferences, specifically designed to support students’ transition from medical ethics education to active participation in the scholarly bioethics community. We discuss the educational aims and didactic foundations of this model and reflect on its transferability and limitations. The Winter School illustrates how advanced medical ethics education can foster critical engagement with ethical debate, scholarly rigour, and the development of academic identity by enabling students not only to study bioethics but also to actively practise scholarly bioethics.

Extended reality (=XR) provides promising opportunities for psychiatry in the future. However, psychiatric patients appear to be particularly vulnerable to virtual exposure. With a focus on virtual embodiment and virtual social interaction, we therefore, 1. describe the specific risks of virtual exposures, 2. discuss them in relation to specific psychopathological symptoms and 3. outline initial strategies that enable safe exposure with a strong emphasis on participatory designs.

Closed-loop neurotechnologies bring great promise for treating neurological and psychiatric disorders. However, the use of artificial intelligence (AI) in their application raises ethical concerns, since AI-driven closed-loop devices may cause unforeseen mental interference that might, absent consent, infringe the user's mental rights. Whether such worries are warranted, however, may depend on whether closed-loop neurotechnologies qualify as moral agents, and on whether they are distinct from the moral agent on whose brain they act. If they are not moral agents, or are not separate moral agents, they will arguably be incapable of infringing the user's mental rights. In this article, we explore different possible agential relationships between the human user and closed-loop neurotechnologies and consider the implications for the protection that our mental rights provide.

Recent developments in the cognitive sciences, particularly the emergence of neurotechnologies and their potential applications in a variety of contexts, have prompted a debate on what freedoms and rights people have in relation to their brains and minds. Lawyers and philosophers are especially interested in the possibilities offered by the neurosciences in conducting risk assessments and risk management. Minds, Freedoms and Rights deepens our understanding of these legal issues by investigating the human rights that relate to the mind and by exploring their implications for possible uses for neurotechnology for criminal rehabilitation or 'neurorehabilitation'. By harnessing and integrating both legal and ethical perspectives, the authors establish possible uses of neurorehabilitation that are cutting-edge yet simultaneously protect and respect human rights and freedoms. This title is also available as open access on Cambridge Core.

This chapter discusses the Dutch Law on Compulsory Mental Healthcare (Wvggz), which aims to strengthen the autonomy of patients with severe mental disorders by recognizing that coercive measures can be used not only to prevent harm, but also to restore autonomy. This approach challenges the traditional notion that coercive measures inherently undermine autonomy. The chapter also explores the unintended consequences of the law, such as increased bureaucracy. We argue that while the Wvggz introduces valuable ideas, its practical implementation has highlighted the challenges of translating legislative goals into effective practices.

Technologies such as virtual reality, wearables, and mobile apps have the potential to improve forensic psychiatric treatment of youths. Meanwhile, these technological advancements have given rise to new, complex ethical challenges. Paying attention to ethics is especially relevant in forensic psychiatric youth settings because of the often coercive context of treatment and the vulnerable patient population. The goal of this viewpoint paper is to identify and discuss important ethical challenges regarding the use of technology in forensic psychiatric youth care. In line with approaches within the domain of ethics, an analysis of relevant scholarly literature was used for this viewpoint paper. First, a general description, an overview of research on effectiveness, and examples from practice are provided for six technologies that can be used in forensic psychiatric youth care: virtual reality, internet-based interventions, mobile apps, wearables, neurotechnology, and games. Next, ethical challenges that are relevant for these technologies are explored, related to informed consent, privacy and data security, reliability and validity, equity, accessibility and usability, undesirable side effects, acceptability of content, persuasiveness, and evidence-based interventions. Interdisciplinary collaboration between researchers, patients, therapists, ethicists, technology developers, and forensic organizations is recommended for timely identification of ethical challenges and suitable solutions. We suggest that patients and therapists should be actively involved throughout all phases of the process, from development of the technology via co-creation to active participation in implementation and evaluation in practice.

Victims have a right to participate in restorative justice practices, also if offenders are detained within forensic mental healthcare. However, the deployment of restorative justice interventions in the context of forensic psychiatry is limited. This study aims to gain more insight in opportunities and challenges regarding victim engagement in forensic psychiatry. To achieve this, a narrative review study and an elite interview study with ten key figures in the field of victim-offender engagement within forensic psychiatry were carried out. Both studies focused on the following three themes: first, the impact of various diagnoses on victim engagement; second, the effects of victim-offender interaction on treatment, and, third, challenges for victim-offender interaction. The main findings are that restorative justice can, in principle, be carried out successfully within a forensic psychiatric context and that no diagnostic category on the part of the offender should be excluded in advance. Furthermore, victim engagement can contribute to the treatment of mentally disordered offenders by increasing awareness, motivation and compliance, improve self-image and uncover areas of concern. Apart from these opportunities, several challenges - such as adequate preparation, correct timing, and expectation management - have to be taken into account for effective restorative justice practices.

Background Technological innovations often come hand in hand with ethical and legal challenges. This especially applies to forensic psychiatry due to its legal framework and the often accompanying obligatory nature of treatment. Aim To identify ethical and legal considerations related to new, non-linguistic technologies in which little to no written language is used, in a forensic psychiatric context. Method A concise ethical and legal analysis of several emerging technologies that can (potentially) be applied within forensic psychiatry, based on relevant scientific literature. Results Technologies such as virtual reality, biosensors, and neuro-interventions offer possibilities to improve forensic psychiatric treatment. However, little is known about their effectiveness and integration into treatment, but also regarding ethical and legal aspects. For each technology, we discuss three important considerations, amongst which persuasiveness, informed consent, privacy, data ownership, and mental integrity. These topics serve as starting points for future research. Conclusion To gain timely insight into ethical and legal considerations and incorporate them into development and implementation processes, it is important to integrate knowledge from ethicists, lawyers, healthcare providers, patients, researchers, technology developers, and policymakers.

The possibility of neurotechnological interference with our brain and mind raises questions about the moral rights that would protect against the (mis)use of these technologies. One such moral right that has received recent attention is the right to mental integrity. Though the metaphysical boundaries of the mind are a matter of live debate, most defences of this moral right seem to assume an internalist (brain-based) view of the mind. In this article, we will examine what an extended account of the mind might imply for the right to mental integrity and the protection it provides against neurotechnologies. We argue that, on an extended account of the mind, the scope of the right to mental integrity would expand significantly, implying that neurotechnologies would no longer pose a uniquely serious threat to the right. In addition, some neurotechnologies may even be protected by the right to mental integrity, as the technologies would become part of the mind. We conclude that adopting an extended account of the mind has significant implications for the right to mental integrity in terms of its protective scope and capacity to protect against neurotechnologies, demonstrating that metaphysical assumptions about the mind play an important role in determining the moral protection provided by the right.

The human hypothalamus modulates mental health by balancing interactions between hormonal fluctuations and stress responses. Stress-induced progesterone release activates progesterone receptors (PR) in the human brain and triggers alterations in neuropeptides/neurotransmitters. As recent epidemiological studies have associated peripheral progesterone levels with suicide risks in humans, we mapped PR distribution in the human hypothalamus in relation to age and sex and characterized its (co-) expression in specific cell types. The infundibular nucleus (INF) appeared to be the primary hypothalamic structure via which progesterone modulates stress-related neural circuitry. An elevation of the number of pro-opiomelanocortin+ (POMC, an endogenous opioid precursor) neurons in the INF, which was due to a high proportion of POMC+ neurons that co-expressed PR, was related to suicide in patients with mood disorders (MD). MD donors who died of legal euthanasia were for the first time enrolled in a postmortem study to investigate the molecular signatures related to fatal suicidal ideations. They had a higher proportion of PR co-expressing POMC+ neurons than MD patients who died naturally. This indicates that the onset of endogenous opioid activation in MD with suicide tendency may be progesterone-associated. Our findings may have implications for users of progesterone-enriched contraceptives who also have MD and suicidal tendencies.