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A qualitative comparison of data infrastructures for COVID-19 health-related data: lessons for the European Health Data Space
The COVID-19 pandemic has represented the first global health emergency to be tackled through widespread data collection via a broad array of digital health technologies. Throughout Europe, data infrastructures for the acquisition, processing, and management of COVID-19 data were either implemented ex novo or “repurposed” towards this end. Analysing and comparing these data practices may hold great value to the upcoming European Health Data Space (EHDS) implementation. This study investigates the implementation of COVID-19 data infrastructures in four European countries–Italy, Sweden, Denmark, and England–to highlight challenges related to technical, ethical, and legal aspects of secondary uses of health-related data, particularly given the implementation of the EHDS. The data infrastructures included in the study reveal profound differences in design and data access practices, partly owing to the social contexts in which they were established. Challenges for data-sharing and integration include fragmentation of standards and requirements, ethical concerns about access by corporate actors to publicly collected datasets, and lack of robust legal bases. Investigating such infrastructures is crucial to probe challenges in data sharing practices within the European context and represents a revealing test case to anticipate opportunities and challenges in aligning current technical and legal standards with EHDS’ requirements.
Moral Enhancement1
The opponents of enhancement do not all set out to defend a common and clearly specified thesis. However, several would either assent or be attracted to the following claim (henceforth, the bioconservative thesis): Even if it were technically possible and legally permissible for people to engage in biomedical enhancement, it would not be morally permissible for them to do so. The scope of this thesis needs to be clarified. This chapter argues that the bioconservative thesis, thus qualified, is false. There is clearly scope for most people to morally enhance themselves. According to every plausible moral theory, people often have bad or suboptimally good motives. The author tentatively argues that it would sometimes be morally permissible for people to biomedically mitigate their counter-moral emotions. The chapter concludes with a scenario consisting of five assumptions that will be morally permissible for people to morally enhance themselves.
Psychedelics as moral bioenhancers: Protocol for a scoping review of ethical arguments for and against.
BACKGROUND: Moral bioenhancement typically refers to the deliberate use of drugs or biotechnologies, potentially alongside other practices, to attempt to improve oneself morally. In addition to general concerns regarding moral self-bioenhancement, the possibility of using psychedelic substances for such purposes raises distinct ethical questions. As a first step in analysing these questions, we intend to perform a scoping review of the existing arguments for and against the use of psychedelics as moral bioenhancers. We will focus primarily on voluntary use by individuals, although voluntary use by couples or small groups will be considered. The present contribution is a protocol for this scoping review. METHODS: Our scoping review will adhere to the Joanna Briggs Institute methodology, which involves five stages: (1) identifying the research question, (2) developing the search strategy, (3) setting inclusion criteria, (4) extracting data, and (5) presenting and analysing the results. We will include both published and unpublished sources if they explicitly present ethical arguments for or against the voluntary use of psychedelics as intentional moral bioenhancers in adults. We will search for relevant studies in Embase, MEDLINE, Web of Science, Google Scholar, The National Library of Medicine, the Cumulated Index to Nursing and Allied Health Literature, Philosopher's Index, the Bioethics Literature Database, EthxWeb, PhilPapers, Stanford Encyclopedia of Philosophy, Philosopher's Index, EBSCO, BASE, and WorldCat. Sources will be excluded if (a) the full text is inaccessible, (b) the main text is in a language other than English, or (c) the focus is not primarily on ethical arguments (for example, focusing primarily on the clinical use of psychedelics for treatment). Two raters will independently assess all articles for eligibility, with disagreements to be resolved with a third reviewer. Data from eligible articles will be charted using a standardised data extraction form. The data will be analysed following PRISMA-ScR guidelines.
The role of the enrolling clinician in emergency research conducted under an exception from informed consent.
The Exception from Informed Consent (EFIC) permits patient enrolment into therapeutic emergency research where obtaining informed consent is challenging. Yet this fails to resolve a core ethical conflict in the research and has generated controversy. This is because existing justification and practice has relied on applying EFIC per study-a wholesale permission to enroll irrespective of circumstance-instead of per patient. Our novel justification for enrolment centers on applying EFIC per patient, which empowers the enrolling clinician to judge whether to enroll patients with an Exception. This contrasts with the idea that clinician judgment is surplus to the judgements already made by institutions in deciding the research may proceed. Instead, we show that enrolling clinician's judgment is ethically significant and should not be overlooked: attending to this strengthens the research ethically and reduces controversy. There should be a bigger role for the clinician in the research enrolment space.
Call for a fairer approach to authorship in publishing biomedical research.
In this Perspective article, we call for a fairer approach to authorship practice in collaborative biomedical research to promote equity and inclusiveness. Current practice does not adequately recognise all contributors involved in different stages of the work and may exacerbate preexisting inequalities. Here, we discuss some key features of contemporary collaborative research practice that complicate authorship decisions. These include the project size, complexity of multidisciplinary team involvement and researchers having varying degrees of expertise and experience. We conclude by making some suggestions to address these concerns.
Is “nature” a policy solution to mental health in schools?
The UK faces a growing youth mental health crisis (NHS, 2023; RCPsych 2025). Schools may play a key role in preventing these difficulties from worsening. The integration of nature-based programs (NbPs) into school settings has been proposed as a policy solution to address such mental health challenges but robust evidence is lacking (Lomax et al., 2024), particularly at the secondary school level. This Sprint utilised an implementation science framework to co-produce evidence on NbPs in secondary schools with stakeholders including policymakers from the Government’s Department for Education (DfE), young people, and educators. Using a range of methodologies we are evaluating effectiveness, amplifying stakeholder voices, and creating actionable, evidence-based education policy insights.
'Why Do You Ask?' Revisiting the Purpose of Eliciting the Public's Moral Judgments About Emerging Technologies.
It is increasingly common for bioethicists to consult with the public to solicit their judgments and attitudes about ethical questions and issues, especially ones that arise with new and emerging technologies. However, it is not always clear what the purpose of this engagement is or ought to be: do bioethicists seek the input of the public to help them arrive at a morally correct justified policy position, or do they seek this input to help them shape and frame their already-established moral position, or something else entirely? In this essay, we discuss four distinct possible functions of collecting moral judgments from the public: issue spotting, messaging for adherence and social stability, substantive moral guidance, and procedural fairness. For each function, we offer core examples from the literature before discussing the strengths and weaknesses attendant to each. We conclude with several preliminary questions bioethicists can ask themselves to clarify their own purpose for soliciting moral judgments from the public.
Ethical considerations in AI for child health and recommendations for child-centered medical AI.
There does not exist any previous comprehensive review on AI ethics in child health or any guidelines for management, unlike in adult medicine. This review describes ethical principles in AI for child health and provides recommendations for child-centered medical AI. We also introduce the Pediatrics EthicAl Recommendations List for AI (PEARL-AI) framework for clinicians and AI developers to ensure ethical AI enabled systems in healthcare for children.
What Does It Take to Trespass on a Person’s Body?
In this article, I begin to develop an account of bodily trespass – a specification of the conditions under which one person infringes another’s right against bodily interference. I first offer a minimal account, intended to capture only the clear cases of bodily trespass. On this account, bodily trespass consists in either bodily touching or significant, non-psychologically-mediated bodily alteration. I then consider whether this account should be broadened to accommodate some plausible, though non-obvious, cases of bodily trespass. These are cases in which a bodily alteration is produced via psychological processes in the target. I argue that, in deciding whether to accommodate such cases within our account, we face a dilemma, and one of considerable practical significance.
Women's wellbeing as an empty declaration? A qualitative exploration of challenges in accessing termination of pregnancy due to fetal anomaly in Germany.
BACKGROUND: The provision of prenatal testing through publicly funded healthcare systems, including non-invasive prenatal testing (NIPT), is frequently justified on the basis of supporting reproductive autonomy and informed choice. This includes decision-making around termination of pregnancy (TOP), including where it is due to a diagnosis of fetal anomaly (TOPFA). In Germany, TOP is regulated under the criminal code. However, it is exempt from punishment, if provided upon request from the woman up to 12 weeks after conception (14 weeks gestation) and following mandatory counselling. After this gestational stage, TOP may be provided where it is necessary to ensure the physical and mental wellbeing of the pregnant woman. However, there is a significant lack of clarity about how to interpret and apply this criterion. Fetal anomaly is often detected or confirmed after the time limit for TOP upon request has passed, which introduces uncertainty whether a fetal indication justifies legal access to TOP. METHODS: This study explores attitudes towards TOP, experiences with decision-making and access, and the implications of the German legal and regulatory frameworks. It draws on a qualitative semi-structured interview study, conducted between 2021 and 2022. Participants were 20 German professionals who have experience or expertise regarding the provision of NIPT, as well as 7 women with experiences of pregnancy, reproductive decision-making and the offer of NIPT. Interviews were conducted in German, and then transcribed, translated, and analysed using thematic analysis. RESULTS: Participants explored the importance of being able to access TOPFA; how the social positioning of TOP as a taboo procedure creates practical and psychosocial barriers to TOPFA access; the tension of who ultimately gets to make the decision about whether TOP can be provided; and how gestational time limits create emotional stress, frustrating informed decision-making and reproductive autonomy. CONCLUSIONS: Our findings highlight that where prenatal testing is provided in the absence of guaranteed access to TOP, women's wellbeing becomes an empty declaration in German healthcare policy.