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OBJECTIVE: Artificial intelligence (AI) is reshaping health and medicine, especially through its potential to address health disparities in low- and middle-income countries (LMICs). However, there are several issues associated with the use of AI that may reduce its impact and potentially exacerbate global health disparities. This study presents the key issues in AI deployment faced by LMICs.
METHODS: Thematic analysis.
METHODS: PubMed, Scopus, Embase and the Web of Science databases were searched, from the date of their inception until September 2023, using the terms \"artificial intelligence\", \"LMICs\", \"ethic∗\" and \"global health\". Additional searches were conducted by snowballing references before and after the primary search. The final studies were chosen based on their relevance to the topic of this article.
RESULTS: After reviewing 378 articles, 14 studies were included in the final analysis. A concept named the \'AI Deployment Paradox\' was introduced to focus on the challenges of using AI to address health disparities in LMICs, and the following three categories were identified: (1) data poverty and contextual shifts; (2) cost-effectiveness and health equity; and (3) new technological colonisation and potential exploitation.
CONCLUSIONS: The relationship between global health, AI and ethical considerations is an area that requires systematic investigation. Relying on health data inherent with structural biases and deploying AI without systematic ethical considerations may exacerbate global health inequalities. Addressing these challenges requires nuanced socio-political comprehension, localised stakeholder engagement, and well-considered ethical and regulatory frameworks.

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This study examines the UK\'s May 2023 judgment in an international organ trafficking and organ tourism case. Human trafficking for organ removal is one of the least understood but growing forms of trafficking worldwide. Countries in the Middle East, Asia, and the Americas are often widely criticized by the international transplant community as sites for organ trafficking. However, we believe that when discussing this issue, it is not just these areas that need to be addressed. What is particularly special is that this case not only involves transnational human trafficking, organ trafficking, and illegal organ transplantation interest chains but also involves the participation of national political officials and complex social and humanistic factors. This article focuses on the current ethical and policy issues involved in organ transplant tourism and organ trafficking and analyzes the implications of this case for our country\'s donation and transplantation work.

OBJECTIVE: Surrogate decision-making by family caregivers for patients with severe brain injury is influenced by the availability and understanding of relevant information and expectations for future rehabilitation. We aimed to compare the consistency of family caregivers\' perceptions with clinical diagnoses and to inform their expectation of prognosis in the future.
METHODS: The Coma Recovery Scale-Revised was used to assess the diagnosis of inpatients with severe brain injury between February 2019 and February 2020. A main family caregiver was included per patient. The family caregiver\'s perception of the patient\'s consciousness and expectations of future recovery were collected through questionnaires and compared consistently with the clinical diagnosis.
RESULTS: The final sample included 101 main family caregivers of patients (57 UWS, unresponsive wakefulness syndrome, 37 MCS, minimally conscious state, 7 EMCS, emergence from MCS) with severe brain injury. Only 57 family caregivers correctly assessed the level of consciousness as indicated by the CRS-R, showing weak consistency (Kappa = 0.217, P = 0.002). Family caregivers\' demographic characteristics and CRS-R diagnosis influenced the consistency between perception and clinical diagnosis. Family caregivers who provided hands-on care to patients showed higher levels of consistent perception (AOR = 12.24, 95% CI = 2.06-73.00, P = 0.006). Compared to UWS, the family caregivers of MCS patients were more likely to have a correct perception (OR = 7.68, 95% CI = 1.34-44.06). Family caregivers had positive expectations for patients\' recovery in terms of both communication and returning to normal life.
CONCLUSIONS: Nearly half of family caregivers have inadequate understanding of their relative\'s level of consciousness, and most of them report overly optimistic expectations that do not align with clinical diagnosis. Providing more medical information to family caregivers to support their surrogate decision-making process is essential.

In accordance with China\'s regulations on the prevention and control of HIV/AIDS, individuals diagnosed with HIV are required to disclose their medical condition when soliciting medical care in Mainland China. Empirical field investigations, however, indicate that people living with HIV (PLHIV) predominantly comply with this mandate only under conditions of absolute necessity. The ensuing conundrum, juxtaposing the imperative of privacy against the duty of disclosure, has materialised into a recurrent vicious cycle in its practical application, intensifying the intrinsic trust disparities characterising doctor-patient interactions. A meticulous scrutiny of pertinent legal precedents, coupled with in-depth field studies, reveals that the genesis of these complications can be traced back to an unforeseen metamorphosis in the legislative intent underpinning HIV/AIDS prevention and therapeutic strategies. While the initial objective was risk mitigation, the effect of enactment in real-world scenarios has significantly decreased. Owing to factors including extensive media reporting as well as prevailing public discourse, PLHIV, rather than being perceived as rights-bearing entities in legal frameworks, are increasingly relegated to the restrictive and dehumanising labels of \'HIV/AIDS\'. As these individuals navigate their rights through alternative non-regulatory channels, circumventing formal legal obligations, their efficacy in actualising these rights is concurrently undermined.

Background: There is growing interest in advancing biobanking and genetic research in many countries, including India. Concurrently, more importance is being placed on participatory approaches involving the public and other stakeholders in addressing ethical issues and policymaking as part of a broader governance approach. We analyse the tools, purposes, outcomes and limitations of engaging people towards biobanking and genetic research governance that have been undertaken worldwide, and explore their relevance to India. Methods: Papers to be reviewed were identified through a targeted literature search carried out using ProQuest and PubMed. Retrieved papers were analysed with the Rpackage for Qualitative Data Analysis using inductive coding and thematic analysis, guided by the Framework Method. Results: Empirical studies on public and community engagement in the context of biobanking and or genetic research show a predominance towards the end of the last decade, spanning 2007 to 2019. Numerous strategies-including public meetings, community durbars, focus group discussions, interviews, deliberations, citizen-expert panels and community advisory boards-have been used to facilitate communication, consultation and collaboration with people, at the level of general and specific publics. Engagement allowed researchers to understand how people\'s values, opinions and experiences related to the research process; and enabled participants to become partners within the conduct of research. Conclusions: Constructs such as \'co-production\', \'engagement of knowledges\', \'rules of engagement\' and \'stewardship\' emerge as significant mechanisms that can address the ethical challenges and the governance of biobanking and genetic research in India. Given the inherent diversity of the Indian population and its varying cultural values and beliefs, there is a need to invest time and research funds for engagement as a continuum of participatory activity, involving communication, consultation and collaboration in relation to biobanking and genetic research. Further research into these findings is required to explore their effective employment within India.

In intensive care units, patients are often restrained to ensure their safety, with physical restraints being the most commonly used method. However, physical restraints compromises the patient\'s freedom, health and comfort, and nurses often face moral dilemmas when deciding whether to use physical restraints. This article examines physical restraints through the four universal principles of autonomy, beneficence, non-maleficence and justice. Through these principles, the authors will critically explore whether the physical restraints of patients by nurses is ethical in practice and what moral issues exist. This paper also explores conflicts and moral dilemmas for nurses in this context. Finally, suggestions are made on changes to education and clinical practice.

BACKGROUND: Social media with real-time content and a wide-reaching user network opens up more possibilities for palliative and end-of-life care (PEoLC) researchers who have begun to embrace it as a complementary research tool. This review aims to identify the uses of social media in PEoLC studies and to examine the ethical considerations and data collection approaches raised by this research approach.
METHODS: Nine online databases were searched for PEoLC research using social media published before December 2022. Thematic analysis and narrative synthesis approach were used to categorise social media applications.
RESULTS: 21 studies were included. 16 studies used social media to conduct secondary analysis and five studies used social media as a platform for information sharing. Ethical considerations relevant to social media studies varied while 15 studies discussed ethical considerations, only 6 studies obtained ethical approval and 5 studies confirmed participant consent. Among studies that used social media data, most of them manually collected social media data, and other studies relied on Twitter application programming interface or third-party analytical tools. A total of 1 520 329 posts, 325 videos and 33 articles related to PEoLC from 2008 to 2022 were collected and analysed.
CONCLUSIONS: Social media has emerged as a promising complementary research tool with demonstrated feasibility in various applications. However, we identified the absence of standardised ethical handling and data collection approaches which pose an ongoing challenge. We provided practical recommendations to bridge these pressing gaps for researchers wishing to use social media in future PEoLC-related studies.

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