This essay analyzes from a personalistic bioethics the model of technological progress supported by an autonomy without controls and an imperative that is governed by the maxim: if it can be done, let\'s do it!, as a necessary and sufficient condition of progress. This puts us on the slippery slope between the technically feasible and the morally lawful. The pioneering work of the philosopher, José Sanmartin Esplugues 2 , urges reflection in the face of a technological profusion that sees the human being as a useful embodied object and offers powers of intervention on human life that were previously unimaginable. The reduction of the person to mere biological-material data opens the door to increasing deshumanization by subordination to the calculations of an instrumental rationalism. Underlying the desire to see ourselves at the top of the world and genetic techniques are the ultimate expression of a longing for human emancipation that aspires to take the reins of evolution through an abstract postbiological imaginary. Sanmartin proposes a model of ethical evaluation and social insertion of technoscientific activity that goes beyond the conventional categories of impact, use and effectiveness to distinguish social, cultural, economic, political and values correlates, in order to embroider a pattern that decides on the means and ends of human life through technologies that are neither innocuous nor neutral. A society without antidotes to manipulation that also teaches us to cultivate utopian dreams about human nature is easily malleable by elites who promise happy worlds and redeem us from our vulnerability.

This article argues the voice of people with dementia was missing from the Australian Royal Commission into Aged Care Quality and Safety (RCAC) Final Report. This absence was notwithstanding that the RCAC was explicitly tasked to inquire into dementia care. The RCAC Final Report is shown to marginalise the perspective and experience of people with dementia in the aged care system at the same time as prioritising substitute voices of experts, advocates, family and care partners. This absence of voice repeats and re-inscribes framing of people with dementia as \"missing persons\". Where people with dementia face practical and legal barriers to participate in civic and legal processes, the RCAC failed to adjust its methodologies to ensure their voices were \"heard\". The RCAC\'s re-inscription of marginalisation of people with dementia raises concerns for the legitimacy and success of its recommendations for dementia aged care reform.

Here, we analyze critical changes in environmental law enforcement in the Brazilian Amazon between 2000 and 2020. Based on a dataset of law enforcement indicators, we discuss how these changes explain recent Amazon deforestation dynamics. Our analysis also covers changes in the legal prosecution process and documents a militarization of enforcement between 2018 and 2022. From 2004 to 2018, 43.6 thousand land-use embargoes and 84.3 thousand fines were issued, targeting 3.3 million ha of land, and totaling USD 9.3 billion in penalties. Nevertheless, enforcement relaxed and became spatially more limited, signaling an increasing lack of commitment by the State to enforcing the law. The number of embargoes and asset confiscations dropped by 59% and 55% in 2019 and 2020, respectively. These changes were accompanied by a marked increase in enforcement expenditure, suggesting a massive efficiency loss. More importantly, the creation of so-called conciliation hearings and the centralization of legal processes in 2019 reduced the number of actual judgments and fines collected by 85% and decreased the ratio between lawsuits resulting in paid fines over filed ones from 17 to 5%. As Brazil gears up to crack-down on illegal deforestation once again, our assessment suggests urgent entry points for policy action.

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OBJECTIVE: This review aimed to analyse the impacts of international economic sanctions on the overall health status of Iranians and the health system performance of Iran, in addition to identifying effective strategies for making the health system resilient to sanctions.
METHODS: A scoping review.
METHODS: Three databases and grey literature were reviewed, and additional papers were identified in the lists of references. Two authors reviewed papers to check duplications and screen through inclusion/exclusion criteria. Furthermore, a narrative approach was employed to synthesise the findings.
RESULTS: Given overall health impacts, economic sanctions are believed to have adverse effects on Iranian\'s health and cause significant financial hardships in accessing healthcare services. These hardships mostly affect those in marginalised and vulnerable groups. Economic sanctions degrade Iran\'s health system by negatively impacting health services\' availability. The detrimental effects of sanctions on economic and social circumstances were also documented. Economic sanctions could also adversely affect health research and education. Most strategies identified for health system resilience to sanctions are related to the health system governance.
CONCLUSIONS: Even if essential medicines and supplies are exempted from the sanction regime, the impact of economic sanctions on public health is unavoidable. The quantification of the effect economic sanctions on different health-related areas needs by further research. The measures identified for dealing with sanction can be considered in other countries but more work is needed to explore how health of people can be resilient against negative consequences of sanctions.

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This hypothetical vignette-based experiment was designed to better understand judges\' and probation officers\' interpretations and use of juvenile risk assessment tools in their decision-making around restrictive sanctions and confinement of youths on the basis of the youths\' risk level and race.
We expected that estimates of the probability of juvenile recidivism would significantly mediate the relationship between a categorical risk descriptor and decisions regarding the ordering confinement of youths. We also hypothesized that youths\' race would serve as a significant moderator in the model.
Judicial and probation staff (N = 309) read a two-part vignette about a youth who was arrested for the first time; in this vignette, race (Black, White) and risk level (low, moderate, high, very high) of the youth were varied. Participants were asked to estimate the likelihood that the youth would recidivate in the following year and their likelihood of ordering or recommending residential placement.
Although we found no simple, significant relationship between risk level and confinement decisions, judicial and probation staff estimated higher likelihoods of recidivism as risk-level categories increased and ordered out-of-home placements at increased rates as their estimations of the youth\'s likelihood of recidivation increased. The youth\'s race did not moderate the model.
The greater the probability of recidivism, the more likely each judge or probation officer was to order or recommend out-of-home placement. However, importantly, legal decisionmakers appeared to apply categorical risk assessment data to their confinement decisions using their own interpretations of risk category rather than being guided empirically on the basis of risk-level categories. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Mobile phone use while driving continues to be a significant road safety concern, despite the severe legal countermeasures to reduce this behaviour. Phone use while driving-related crashes have been demonstrated to be an issue in rural areas, yet research into the impact of legal sanctions on phone use while driving has primarily focussed on urban areas. Therefore, this study aimed to investigate differences in enforcement of phone use while driving between rural and urban environments as reported by police officers. In addition, to provide necessary context, this study aimed to explore how the police officers perceive differences in drivers\' engagement in phone use while driving between rural and urban environments. To address these aims, a total of 26 police officers from Queensland, Australia (18 with both rural and urban experience, 6 with only rural experience and 2 with only urban experience) completed an interview. A total of seven themes were developed from the data. Several differences between rural and urban environments were identified concerning different types of phone offending behaviour, as well as different resources, management and infrastructure that can impact police enforcement. For example, it was suggested that drivers in rural areas have less reasons to use their phone while driving. Nevertheless, when this behaviour does occur, it is more challenging to enforce this law in rural compared to urban environments. The results not only provide important contextual information for phone use while driving research, but also suggest that enforcement strategies for this behaviour may need to be recontextualised to incorporate the more nuanced aspects of rural policing.

This Viewpoint discusses the benefits and potential harms of using artificial intelligence (AI) algorithms in medicine and proposes the collaborative creation of a Code of Conduct for AI in Health Care.

Immigration enforcement policies are associated with immigrants\' barriers to health care. Current evidence suggests that enforcement creates a \"chilling effect\" in which immigrants avoid care due to fear of encountering enforcement. Yet, there has been little examination of the impact of immigrants\' direct encounters with enforcement on health care access. We examined some of the first population-level data on Asian and Latinx immigrants\' encounters with law and immigration enforcement and assessed associations with health care access.
We analyzed the 2018 and 2019 Research on Immigrant Health and State Policy survey in which Asian and Latinx immigrants in California (n=1681) reported on 7 enforcement experiences (eg, racial profiling and deportation). We examined the associations between measures of individual and cumulative enforcement experiences and the usual sources of care and delay in care.
Latinx, compared with Asian respondents, reported the highest levels of enforcement experiences. Almost all individual enforcement experiences were associated with delaying care for both groups. Each additional cumulative experience was associated with a delay in care for both groups (OR=1.30, 95% CI 1.10-1.50). There were no associations with the usual source of care.
Findings confirm that Latinx immigrants experience high levels of encounters with the enforcement system and highlight new data on Asian immigrants\' enforcement encounters. Direct experiences with enforcement have a negative relationship with health care access. Findings have implications for health systems to address the needs of immigrants affected by enforcement and for changes to health and immigration policy to ensure immigrants\' access to care.