Trace to the source of public health ethics is neither medical ethics nor bioethics. This paper begins by exploring the slow development of public health ethics and argues that a true understanding of public health ethics requires not only an understanding of public health itself, but also the inclusion of perspectives from the philosophy of public health, health economics and even political philosophy. Only then can we gain a deeper understanding of the characteristics and essence of public health, which in turn will help to highlight the ethical issues involved in public health interventions and public health ethics practice. It remains difficult to outline a satisfactory theory of public health ethics; however, the path to consensus requires a foundation of the core values of public health ethics. For instance, it is necessary to precisely define concepts such as groups, communities, populations, public goods, common interests, solidarity, reciprocity, welfare, well-being and justice. A comparative study of Eastern and Western philosophical and ethical perspectives would help us to gain a more profound understanding of these issues.

BACKGROUND:The impetus for policies promoting medical data sharing in China has gained significant traction. Nonetheless, the present legal and ethical framework governing the research use of medical data in China, is characterized by a more restrictive rather than permissive approach. The proportion of Chinese medical data being leveraged for scientific research still has room for improvement at present, indicating a significant untapped potential for advancing medical knowledge and improving healthcare outcomes. Building upon this research, we aim to delve deeper into the challenges researchers encounter in the sharing of medical data through focus group interviews. METHODS:We conducted two focus group interviews study with researchers representing diverse disciplines to explore their perspectives on 21 June 2021 and 28 July 2021. A total of seventeen researchers willingly participated in this study, representing various professional backgrounds. Similar codes were merged. Research team discussions were also utilized to select interviewees' statements that were regarded as typical or representative. RESULTS:The respondents demonstrated a strong understanding that medical data should not be disseminated arbitrarily, recognizing the importance of sharing data in compliance with laws. Through the interview, we found that although respondents stressed the importance of careful consideration regarding if and when this information can be responsibly released, none of the respondents raised the issue of necessitating consent from data subjects for the research use of medical data. This observation sharply contrasts with the stringent separate consent provisions for secondary data use outlined in the PIPL. CONCLUSIONS:The findings from the focus group studies shed light on researchers' barriers and ethical challenges towards medical data sharing for scientific research, highlighting their deep concern for data security and cautious approach to sharing. The key objectives aimed at facilitating and enabling the reuse of medical data encompass enhancing interoperability, harmonizing data standards, improving data quality, safeguarding privacy, ensuring informed consent, incentivizing patients, and establishing explicit regulations pertaining to data access and utilization.

Objective:Public health emergencies expose a significant threat to human life and health. How to efficiently conduct biomedical research while complying with ethical norms is an important way to response to public health emergent events such as pandemic outbreak. In 2023, the National Health Commission, the Ministry of Education, the Ministry of Science and Technology, and the National Administration of Traditional Chinese Medicine jointly issued the " Measures for Ethical Review of Life Sciences and Medical Research Involving Human Subjects", which requires the ethics committee to construct an ethical review system in advance, including, generally, the ethics committee should conduct ethical review and provide review opinions within 72 hours. Is this measure feasible and does it have any unreasonable aspects?Methods:Literature review and status quo analysis are two main methods, this article combs the international guidelines issued by World Health Organization, the Council for International Organizations of Medical Sciences and the Nuffield Council of Bioethics, selects the content related to research under the circumstances of public health emergencies, take the Hofstede′s Cultural Dimensions Theory into consideration of the complexity of quality and quantity of research during the COVID-19 pandemic in China.Results:After analyzing, this article argues preliminarily that the requirement and emphasize on ethical review system development issued by the four ministries in China is very timely and necessary. However, the requirements for review time limits is inconsistent with international consensus, and might pose substantive challenges to the independence of the ethics committee's work.Conclusions:Scientificity and ethics are the soul of biomedical research, and the basic requirements of these two aspects cannot be undermined due to the special nature of public health emergencies. However, procedures simplifiable are worth exploring.

在人类辅助生殖技术下,单身女性冻卵请求因主体上的单身身份被限制,也因非医学化目的和不确定性风险被阻滞,还因冻卵与人类辅助生殖的关系不清被束缚.如果仅从实在法出发,将它视为一项法律权利,它会受到双重限制,即因效仿苏联而形成的历史性法文化局限导致政策法遗留与制定法缺失和因《立法法》的立法保留原则致使其在现有规范体系下存在适用困境.如果回到自然法的主张,将它视作一项自然权利进行保护,它的权利基础就可以通过从纯粹自然状态、从基于人性的自然法之"善"以及从自爱的自我保存这三个维度被解释为生命权、生育权和身体权.继而从个体在生命维持上的有限性、个体作为人的普遍性和个体身体的可延续性这三个方面论证自然法对走出法律权利框架下实在法桎梏的意义,为单身女性冻卵请求提供辩护,设计出一条在自然法意义上基于自然权利的补正路径.

The COVID-19 pandemic exposed social shortcomings and ethical failures, but it also revealed strengths and successes. In this perspective article, we examine and discuss one strength: the duty to care. We understand this duty in a broad sense, as more than a duty to treat individual patients who could infect health care workers. We understand it as a prima facie duty to work to provide care and promote health in the face of risks, obstacles, and inconveniences. Although at least one survey suggested that health care workers would not respond to a SARS-like outbreak according to a duty to care, we give reasons to show that the response was better than expected. The reasons we discuss lead us to consider normative accounts of the duty to care based on the adoption of social roles. Then, we consider one view of the relationship between empirical claims and normative claims about the duty to care in the COVID-19 pandemic. Here, we draw insight from Mengzi, with an emendation from Dewey. Our perspective leaves many question to research, but one point seems clear: there will be future pandemics and the need for health care workers who respond.

ChatGPT是一种由OpenAI训练的、基于GPT-3.5和GPT-4架构的大型语言模型，是可用于疾病监测、药物信息提供、虚拟医疗助理等医疗健康的聊天机器人的示例。作为一种语言模型，ChatGPT旨在为基于文本的输入生成类似人类的响应，这使得它非常适合回答问题和提供与健康相关的建议。虽然ChatGPT可以使医疗保健工作者从一些繁琐的事务和繁重的劳动中解放出来，但对其专业技能的取代也会导致前所未有的技术性失业危机。此外，与其他新兴科技产物一样，ChatGPT在医疗健康领域的应用无可避免也充满"阳光下的暗礁"。

This chapter introduces the background to organ donation and transplantation in mainland China. First, it briefly describes China’s current healthcare system and the development of organ transplantation. Then it introduces some important legislation and landmark policies regarding organ donation in recent years. Finally, it presents the organ donation operation system and its relevant features in mainland China.

BACKGROUND: Shared decision-making (SDM) has broad application in emergencies.Most published studies have focused on SDM for a certain disease or expert opinions on future research gaps without revealing the full picture or detailed guidance for clinical practice.This study is to investigate the optimal application of SDM to guide life-sustaining treatment (LST) in emergencies. METHODS:This study was a prospective two-round Delphi consensus-seeking survey among multiple stakeholders at the China Consortium of Elite Teaching Hospitals for Residency Education.Participants were identified based on their expertise in medicine, law, administration, medical education, or patient advocacy.All individual items and questions in the questionnaire were scored using a 5-point Likert scale, with responses ranging from "very unimportant" (a score of 1) to "extremely important" (a score of 5).The percentages of the responses that had scores of 4-5 on the 5-point Likert scale were calculated.A Kendall's W coeffi cient was calculated to evaluate the consensus of experts. RESULTS:A two-level framework consisting of 4 domains and 22 items as well as a ready-touse checklist for the informed consent process for LST was established.An acceptable Kendall's W coeffi cient was achieved.CONCLUSION: A consensus-based framework supporting SDM during LST in an emergency department can inform the implementation of guidelines for clinical interventions, research studies, medical education, and policy initiatives.

疾控人员在公共卫生突发事件应对中一直发挥着重要的作用,但也面临着诸多伦理问题和挑战.通过对来自10个省份的一线疾控人员进行质性焦点组访谈,围绕疾控人员在新冠防控中的主要职责任务,从流调溯源、信息共享与发布、隔离管控和社区防控和新技术的应用四个方面对疾控人员在公共卫生事件应对中所面临的伦理学挑战进行了梳理,并进行了进一步分析.为未来的公共卫生突发事件应对从数据的分享与利用,科学防控的全面理解以及提升公众的公共卫生意识与伦理学支持等方面提出意见和建议.

The ISSCR has developed the Informed Consent Standards for Human Fetal Tissue Donation and Research to promote uniformity and transparency in tissue donation and collection. This standard is designed to assist those working with and overseeing the regulation of such tissue and reassure the wider community and public.

公共卫生领域本身天然地把健康和政治密切地联系在一起,这一特点使得探索传染病防控伦理离不开对科学、政治、历史文化和制度等因素的综合考量.简要梳理英国、美国和中国公共卫生历史中与传染病防控相关的典型事件,尝试从公共卫生与政治的关系视角归纳传染病防控伦理中的科学被边缘化、防控政策援引前任而后果隔代遗传以及不同国家之间难以比较高下但各自都有改善空间等特点,提出应正确看待疫情防控中个人自由与公共健康的关系,以相称性原则处理生命第一与经济和社会生活的关系,疫情防控需要全球行动,民族、地区、国家的利益应置于全球整体利益视域中衡量.

Click to increase image sizeClick to decrease image sizeThis article is referred to by:Capacities to Refuse Treatment: A ReplyThis article refers to:Three Kinds of Decision-Making Capacity for Refusing Medical Interventions DISCLOSURE STATEMENTNo potential conflict of interest was reported by the author(s).Additional informationFundingThe author acknowledges the support from China-US Center for Medical Professionalism, Peking University Health Science Center.

It is still common for terminally ill patients to suffer from pain, and the development of palliative care faces many obstacles. The value of death to human society is ignored, and the intrinsic relationship between the meaning of life and the value of death has not been fully explored. This article discusses the current status of palliative care in China, how clinicians reflect and respond, the change of the whole society's concept of palliative care, and suggestions for action, and tries to provide a medical humanistic perspective for walking out of the dilemma of palliative care.