As a result of the COVID-19 global pandemic, paramedics in the UK face unprecedented challenges in the care of acutely unwell patients and their family members. This article will describe and discuss a new ethical dilemma faced by clinicians in the out-of-hospital environment during this time, namely the delivery of bad news to family members who are required to remain at home and self-isolate while the critically unwell patient is transported to hospital. I will discuss some failings of current (...) practice and reflect on some of the ethical and practical challenges confronting paramedics in these circumstances. I conclude by making three recommendations: first, that dedicated pastoral outreach teams ought to be set up during pandemics to assist family members of patients transported to hospital; second, I offer a framework for how bad news can be delivered during a lockdown in a less damaging way; and finally, that a new model of bad news delivery more suited for unplanned, time-pressured care should be developed. (shrink)

The Alexandra District Ambulance Service is the only volunteer-based ambulance service in Victoria, Australia. It provides an opportunity to reflect on the ethical issues surrounding the delivery of ambulance service by volunteers, and its impact on the community.

필자는 본 논문을 통해 서구 형이상학이 제시하는 몸의 위상을 분석한 뒤 새로운 몸 개념을 통해 기존의 몸의 도식의 전복 가능성을 고찰해 보고자 한다. 데카르트에 의해 수립된 몸의 도식은 몸-자동기계(body-mecanic)와 의식조정-자동기계라는 이중의 층위로 분절화되어 있는데 우리는 논증을 통해 이것을 비판적으로 분석하도록 할 것이다. 기존의 몸 도식이 ‘메카닉(mecanic)’이라는 정합적이고 기능주의적인 유기체 논리에서 벗어나지 못하고 있다는 점에 주목하여, 필자는 들뢰즈와 가따리의 “기관 없는 신체(Corps sans organes)” 개념의 프리즘을 통해 “장기-몸(intestins-corps)”이라는 새로운 몸 개념을 제시하고자 한다. 장기-몸(intestins-corps)은 일련의 정합적이고 유기체적인 질서로부터 적출되어 나와 카오스적인 에너지로 (...) 들끓으며 이질적 요소들과의 무한연접으로 열려있는, 새로운 차원의 몸이다. 이러한 장기-몸의 봉기를 가장 잘 나타내주는 사태는 다름 아닌 극한고통이 도래하는 출산이라고 본다. 필자는 출산이 어떤 의미에서 ‘장기-몸’이 실질적으로 가동되는 상태인지를 지젝의 논의의 분석을 통해 심도 있게 고찰할 것이다. 또한 출산을 거친 자들이 상징질서로 편입되지 않고 금기를 깨고 되돌아오는, 살아있는 망자(the living dead)임을 지젝의 논의로부터 분석해 보겠다. 이로서 출산과 같은 극한고통의 체험이 갖는 카오스적 파괴의 힘이 어떤 측면에서 상징적 질서에 균열을 가할 수 있는지도 발터 벤야민의 ‘신적 폭력’ 개념을 착안해 고찰할 것이다. (shrink)

In this article, we use the principlist approach to identify, analyse and attempt to solve the ethical problem raised by a pregnant woman's request for cesarean delivery in absence of medical indications.We use two different types of premises: factual (facts about cesarean delivery and specifically attitudes of obstetricians as derived from the EUROBS European study) and value premises (principles of beneficence and non-maleficence, respect for autonomy and justice).Beneficence/non-maleficence entails physicians' responsibility to minimise harms and maximise benefits. Avoiding its (...) inherent risks makes a prima facie case against cesarean section without medical indication. However, as vaginal delivery can have unintended consequences, there is a need to balance the somewhat dissimilar risks and benefits. The principle of autonomy poses a challenge in case of disagreement between the pregnant woman and the physician. Improved communication aimed to enable better informed choice may overcome some instances of disagreement. The principle of justice prohibits unfair discrimination, and broadly favours optimising resource utilisation.Available evidence supports vaginal birth in uncomplicated term pregnancies as the standard of care. The principlist approach offered a useful framework for ethical analysis of cesarean delivery on maternal request, identified the rights and duties of those involved, and helped reach a conclusion, although conflict at the individual level may remain challenging. (shrink)

Partially because of the high cost of developing and maintaining cold chains, systems needed to keep heat-labile vaccines under adequate refrigeration from their points of manufacture to their administration in the field, the Joint WHO/FAO Expert Committee on Zoonoses (i.e., the approximately four fifths of all described human infections that people share with other vertebrate animals) recommended in 1982 operation of common cold chains by health and veterinary services in rural areas. Following this recommendation, a 1984 pilot level initiative in (...) medical-veterinary intersectoral cooperation should be regarded as a practical way to deliver human primary health care to currently neglected African pastoralists, and as a potential core program for development efforts overall within arid and semiarid areas of the African continent. (shrink)

The radical transformations caused by the rapid development of information and communication technologies in the mid-1990s prompted the transition to the knowledge society which identified the key role of knowledge as the most important and valuable capital of organizations and had a decisive impact on the development of corporate training. In our study, we aimed to analyze the training methods used in American companies in the knowledge society, particularly, their feasibility, features, benefits and possible limitations. The results of our study (...) show that, at present, e-learning is considerably more widely used in American companies than instructor-led classroom training. Most organizations use blended learning which implies the combination of e-learning methods and instructor-led learning methods. A powerful stimulus for the wide implementation of e-learning methods was produced by the COVID-19 pandemic when the use of educational technologies made it possible for the companies not only to continue training and development of their employees but also to implement tactical and strategic practices which will have long-term implications for the future of the training industry. The most widely used e-learning methods in American companies are virtual classroom/webcast, online or computer-based methods, social learning, augmented reality, virtual reality, and artificial intelligence. In spite of certain limitations of e-learning methods, they have a number of important benefits which allow companies to expand access to training, save costs, increase adaptability and flexibility of learning programs, etc., and thus satisfy their needs in qualified employees. (shrink)

In the discipline of practical theology, one finds a long history of linking the name of the field to diaconiology, in which you find the Greek word diaconia, directly translated as 'service'. For good and scientific reasons, the field changed its name to practical theology in some Faculties of Theology but that does not take away the fact that this field of research is still very much engaged in the broad area of 'service of all kinds'. The purpose of this (...) article was to do a descriptive investigation into the problems and challenges of service delivery in the suburb of Belhar (Cape Town), specifically looking at the role of leadership during a (new) time of struggle. As part of the normative task, the researcher took a closer look at the Belhar Confession as a prophetic stance in this regard. In an ironic twist, we see in these events the struggle between the real and the ideal that is typical of many places in the country facing problems with service delivery. The Church often thinks it knows what the world wants from it - inspiration, 'leadership,' clear teaching. But surely what the world is most hungry for is the simple knowledge that healing is possible - not by forgetting or minimizing outrages and sufferings but by sheer, obstinate, costly commitment to work with the grain of grace. (Rowan Williams, Archbishop of Canterbury, in Lapsley 2012:i). (shrink)

Herpes simplex virus (HSV)‐derived vectors are currently being developed for the introduction of foreign DNA into neurons. HSV vectors can facilitate a range of molecular studies on postmitotic neurons and may ultimately be used for somatic cell gene therapy for certain neurologic diseases. In this article, the salient features of the pathogenesis and molecular biology of HSV relevant to its use as a vector are described, along with an overview of the methods used to derive these vectors. The accomplishments which (...) have been made to date using the HSV vector system are discussed, with emphasis on the issues of this technology which remain to be addressed. HSV has the potential to be a most useful tool for neuronal cell transgenesis and it is likely that important neurobiological questions will be answered using this vector system. (shrink)

I hypothesize here that the ability of probiotics to synthesize neuroactive compounds provides a unifying microbial endocrinology‐based mechanism to explain the hitherto incompletely understood action of commensal microbiota that affect the host's gastrointestinal and psychological health. Once ingested, probiotics enter an interactive environment encompassing microbiological, immunological, and neurophysiological components. By utilizing a trans‐disciplinary framework known as microbial endocrinology, mechanisms that would otherwise not be considered become apparent since any candidate would need to be shared among all three components. The range (...) of neurochemicals produced by probiotics includes neurochemicals for which receptor‐based targets on immune and neuronal elements (intestinal and extra‐intestinal) have been well characterized. Production of neurochemicals by probiotics therefore allows for their consideration as delivery vehicles for neuroactive compounds. This unifying microbial endocrinology‐based hypothesis, which may facilitate the selection and design of probiotics for clinical use, also highlights the largely unrecognized role of neuroscience in understanding how microbes may influence health.Editor's suggested further reading in BioEssays Harvesting the biological potential of the human gut microbiome Abstract. (shrink)

We present the case of a 36-year-old woman who has experienced three lost pregnancies; during the most recent loss, a full term pregnancy, she almost died from complications of placental abruption. She is now completing the 34th week of gestation and is experiencing symptoms similar to those under which she lost the previous pregnancy. Despite a lack of specific medical indications, the patient and her husband firmly but politely request that the attending obstetrician/perinatologist perform an immediate cesarean section in order (...) to alleviate the couple’s anxiety about possibly never having a family. Discussing the case are an experienced perinatologist, a neonatologist, a regional perinatal center coordinator, and a clinical ethicist. (shrink)

In this article, I will argue that the delivery of healthcare could be an act of resistance, that is, day‐to‐day, routine and perhaps mundane acts, undertaken in the course of the delivery of health services, which for many could also be considered otherwise routine care. I first consider how resistance has been conceptualised. How we understand resistance will determine if we believe healthcare could be conceptualised this way. I will show how resistance has been applied to day‐to‐day struggles (...) elsewhere and argue that it can clearly encompass open, collective dissent and more subtle, day‐to‐day action that does not necessarily make clear political demands. I go on to introduce some examples, where the delivery of health services could be conceptualised as resistance. While I advocate for a broad understanding of resistance, clearly not every act could be considered resistance; I will consider some points of tension and contention in utilising resistance to describe the delivery of health services, in particular discussing the issue of intent and opposition as they relate to resistance. Finally, while I hope that I make a convincing case, one final issue remains, namely, why turn to resistance at all, when many of the examples that I provide could be labelled using concepts that are more widely utilised. I will offer some general reflections on this point, speaking to the benefits and potential of resistance. (shrink)

James Walsh and Moira McQueen accurately conclude that the early delivery of anencephalic fetuses is morally acceptable, but the reasoning they use to reach that conclusion is flawed. First, the principle of double effect does not require a weighing of good and evil, but rather seeks a sufficient reason for tolerating the physical evil indirectly intended. Second, the principle of double effect requires a clear distinction between physical and moral causality. Third, the Catholic moral tradition will not admit direct (...) and intended killing of the innocent. Rather, early delivery of anencephalic fetuses is permissible because of the pathology associated with delivery of anencephalic fetuses at full term. Thus, the early delivery of an anencephalic infant is acceptable if the purpose of the moral act is avoiding a pathological condition on the part of the mother. (shrink)

Interest in home birth appears to be growing among American women, and most obstetricians can expect to encounter patients who are considering home birth. In 2011, the American College of Obstetricians and Gynecologists (ACOG) issued an opinion statement intended to guide obstetricians in responding to such patients.In this article, I examine the ACOG statement in light of the historical and contemporary clinical realities surrounding home birth in the United States, an examination guided in part by my own experiences as an (...) obstetrician in home-birth-friendly and homebirth-unfriendly medical milieus. Comparison with other guidelines indicates that ACOG treats home birth as an ethical exception: comparable evidence leads to strikingly different recommendations in the case of home birth and the case of trial of labor following a prior cesarean; and ACOG treats other controversial issues that involve similar ethical questions quite differently.By casting the provision of information as not just the primary but the sole ethical responsibility of the obstetrician, ACOG statement obviates obstetricians’ responsibilities to provide appropriate clinical care and to make the safest possible clinical environment for those mothers who choose home birth and for their newborns. What, on its face, seems to be a statement of respect for women’s autonomy, implicitly authorizes behaviors that unethically restrain truly autonomous choices. Obstetricians need not attend home births, I argue. Our ethical duties do, however, oblige us (1) to refer clients to skilled clinicians who will attend home birth, (2) to continue respectful antenatal care for those women choosing home birth, (3) to provide appropriate consultation to home birth attendants, and (4) to ensure that transfers of care are smooth and nonpunitive. (shrink)

Hydroxycamptothecin is a potent antineoplastic agent that has shown efficacy against multiple tumor lines in vitro. eww140918dxn This is the first study to investigate the release, distribution, and efficacy of hydroxycamptothecin which was incorporated into the biodegradable polymer Polylactic Acid (PLA), and implant into brain directly. In vitro release curve generated showed that a large initial release occurred over the first three days and was followed by a steady, but considerably slower rate of release over the next 25 days. After (...) implanting the discs into 40 male SD rats, the animals were followed up to 28 days, where the concentration in brain tissue was far higher than that in peripheral blood at the each of the eight time-points evaluated, and it was also within the therapeutic range for C6 cells tested in vitro. The in vivoefficacy of the discs was evaluated with rats inoculated intracranially with C6 glioma and treated with hydroxycamptothecin polymer compared to intravenous as well as intratumoral injections; the median survival is 21.1, 13.9, 14.9 days, respectively. Given these data, we conclude that the biodegradable polymer PLA releases hydroxycamptothecin, producing tumoricidal levels in brain tissues and prolonging survival in a rat glioma model. (shrink)

Inside and outside of a Christian worldview, bioethicists have discussed ectopic pregnancy at some length as a maternal-fetal vital conflict. Most bioethicists agree that methotrexate and salpingostomy are low-risk, successful interventions for this life-threatening pathology, and are thus beneficent, just, and wholly acceptable. A small cohort of Christian, largely Catholic, bioethicists have reservations about methotrexate and salpingostomy, but cannot resolve their internal disputes about these because of flawed casuistry. This paper aims to settle the issue about whether methotrexate and salpingostomy (...) are acceptable within a Catholic worldview: despite the best arguments in favor of methotrexate as a moral option, it is morally unacceptable, and despite hesitation about salpingostomy related to analogies with previable delivery, it is the optimal procedure for ectopic pregnancy. (shrink)

This article proceeded from the assumption that the theme of service delivery in present-day South Africa could well be qualified by the notion of 'crisis', to the extent that this qualification, from a theological perspective and on the basis of comparative social analysis, well recalls the statements in such critical and profound theological documents as The Kairos Document and Evangelical Witness in South Africa on the 'crisis' in the latter years of apartheid. The further recognition that the theme of (...) service delivery constitutes an essentially new focus for practical-theological scholarship in South Africa led the author, who has a pertinent interest in the field of Christian diaconia, to thereupon go the full circle of practical-theological interpretation in developing such a focus. This was done by, firstly, attempting to develop a deeper contextual understanding of the problem of service delivery in the country on the basis of the prevailing debate on service delivery in South Africa, after which the ideas from conceptualisations of two different modes of diaconal practice within contexts of endemic poverty in the practical-theological literature were explored. The discussion concluded with a more pertinent consideration of the extent to which these two conceptualisations could be taken as providing direction in conceptualising a transformational diaconal response to the current service-delivery problem. (shrink)

Since 2016, drones have been deployed in various development projects in sub-Saharan Africa, where trials, tests, and studies have been rolled out in countries, including Tanzania, Uganda, Rwanda, Malawi, Ghana, and the Democratic Republic of the Congo. The use cases of drones vary, ranging from imagery collection to transportation of vaccines, lab samples, blood products, and other medical supplies. A wide range of stakeholders is involved, including governments, international organizations, educational institutions, as well as industry. Based on a field study (...) conducted in 2019, this article investigates how drones are used for medical supply delivery in Malawi-a country where the community is underserved for healthcare and related infrastructure underdeveloped, while airspace is largely open and regulations generally relaxed. The objective of presenting this case study is to contribute to the evidence regarding the rapid deployment of medical cargo drones across the African continent, and to spark critical reflections over the utility, suitability, and impacts of incorporating drones in the existing health supply chain systems in resource-poor settings. The discussion revolves around two aspects: 1) the emergent “African Drone Rise”-is it ok “as it is Africa”? and 2) the normative role of technology in the aid sector-is it “a solution looking for a problem”? In conclusion, a call for more structured guidance for the systematic examination and evaluation of the medical cargo drone case is raised. (shrink)

The unprecedented outbreak of the novel coronavirus has led to a great shift toward online retailing and accelerated the need for contactless delivery. This study investigates how technological and health belief factors influence consumer acceptance of autonomous delivery robots. Anchored in four behavioral theories [i.e., technology acceptance model, health belief model, perceived value theory and trust theory], a synthesized model is developed. A total of 500 valid responses were collected through an online questionnaire in Singapore, and structural equation (...) modeling was conducted to examine the responses. The results revealed that perceived ease of use, perceived usefulness, perceived susceptibility, perceived severity, self-efficacy and cues to action have a positive and significant influence on consumers’ perceptions of the value of ADRs. The total effect analysis also showed that perceived VAL strongly affects consumer acceptance of ADRs. Academically, this study introduces both technological and health belief factors to explain consumer acceptance of ADRs. It also provides recommendations for policymakers and autonomous delivery robot developers on policy formulation, public communication, product design and infrastructure development. (shrink)

My paper aims to find potential elements of comparison between ancient oratoria popularis and modern populist oratory. I will consider case studies drawn from Gracchan speech style and from the oratory of Donald Trump.

Cochran has argued that Catholic health care occupies a “unique place on the border of public and private life”. Catholic health care is accountable to both its religious and sacramental traditions and its public responsibilities. It is inevitable that “border skirmishes” will arise. Yet there is no single formula for suggesting what public-private collaboration should comprise or how conflicts between values ought to be resolved. It may be, as Cochran suggests, that increasingly bitter conflicts over widely valued services such as (...) sterilization, combined with market pressures to conform to for-profit trends in health care, will make divestiture of faith-based hospitals in favor of other types of church-community partnerships the best course for the future. (shrink)

Within a given culture – whether industrialized or more tradition oriented – essentially the same fundamental medical theories, practices, and pharmacopoeia tend to be applied to human and non-human sickness and patients. In modern industrialized societies, however, healthcare services are sharply divided between human and veterinary medicine. There is likewise a sharp division between practitioners in these two health sectors: medical doctors and veterinarians. Yet in non-Western, traditional or indigenous medical systems, the same practitioners often treat both humans and animals. (...) There is a growing body of literature that attests to the efficacy of traditional health practices and herbal medicines for the prevention and treatment of both human and livestock ailments.The authors argue for an intersectoral approach to human and veterinary health services in poor countries, especially those targeted to rural people with LIMITED access to modern health services. Extension of conventional medical and veterinary services is particularly difficult and costly in Third World countries where the necessary infrastructure (roads, clinics, labs, cold chains, etc.) is poorly developed and where much of the populace and their livestock reside in remote, rural areas, or where people may be nomadic or transhumant. Consideration should therefore be given to the joint delivery of human and livestock healthcare and related services, as well as to linking informal, ethnoveterinary practices and practitioners with more formalized systems of veterinary AND medical practice. Several advantages of such an approach are identified and explored. (shrink)

ABSTRACT Although dominant discourses of various kinds are frequently reproduced on talk radio, the fundamentally collaborative nature of the medium also means that it is able to serve as a channel through which to challenge these discourses. Using Critical Discourse Analysis, this article examines how neoliberal ideology structures discussions around ‘service delivery protest’ on South African talk radio, and explores some of the roles that talk radio is, and is not, able to play in constructing resistance to neoliberal ideology. (...) Our analysis yielded two discourses, namely: naturalisation of the commodification of everyday life, and market over welfare – both of which seemed to cohere with neoliberal frameworks and rationalities in different ways. We conclude by suggesting how radio can be used to denaturalise neoliberalism’s impulse towards making common sense conditions that enable economic oppression and exploitation. (shrink)

Fast delivery to customers required Amazon fulfillment center employees to meet high daily productivity quotas. In some of the centers, robots and people worked together. The efficiency of the robots and the company’s productivity standards, made it challenging for workers to avoid injury. Candace accepted a position in a center utilizing robots and was injured on the job, just like hundreds of others. Her injuries and lack of workplace accommodations prevented her from meeting productivity quotas and consequently jeopardized her (...) job. She wondered if customers understood the human cost incurred to achieve such fast delivery and if it was ethical to subject employees to such work environments. Students are asked to analyze the situation from various ethical perspectives and offer their opinions to Candace. During their analysis they will learn about ethics, ethical standards, stakeholders, and corporate social responsibility. (shrink)

Delivery riders became frontline workers who assisted everyone in getting their daily supplies. They transported them to their destinations when the pandemic started, and everyone had to stay home to stop the COVID-19 virus from spreading. Thus, this study explores the experiences, challenges, and coping mechanisms of 15 Female Delivery Riders in Bulacan, Philippines. The study employed Heideggerian Phenomenology and Interpretative Phenomenological Analysis (IPA). Further, the following themes arise: (1) The Realist, (2) The Accommodated, (3) The Vulnerable, and (...) (4) The Determined. These themes highlighted the experiences and challenges faced by the participants. Moreover, it is highly suggested that female employees should be given preferential assistance given their physical capabilities and role in the family. Thus, local government units should provide an alternative source of income that will allow them to have quality time with their family, especially their children. (shrink)

In “Practical Knowledge of Language”, C.-h. Tsai criticizes the arguments in “Swimming and Speaking Spanish” (this issue, pp. 331–341), on the grounds that its account of knowledge of language as knowledge-how is mistaken. In its place, he proposes an alternative account in terms of Russell’s concept “knowledge-by-acquaintance”. In this paper, I show that this account succeeds neither in displacing the account in Swimming and Speaking Spanish nor in addressing Tsai’s main concern: solving the “delivery problem”.

Definition of the problem: The rapid pace of medical progress has drawn renewed attention to the various possible ways of treating dead or brain-dead pregnant women since the 1980's. The discussion today revolves around medical, social, legal and economic aspects. The historical areas of conflict which surrounded deliveries carried out on dead mothers (usually by means of a Sectio in mortua, nowadays known as a perimortem Caesarean section) and their significance in today's debate are, for the most part, regarded as (...) being of little relevance.Arguments: The history of the Sectio in mortua was, for a long time, influenced by the difficulty in establishing whether the mother and foetus were actually dead, by the degree of autonomy of the foetus in the womb, by religious issues, by the lack of acceptance among the people because of their irrational fears concerning the operation and by legal regulations and constraints especially in relation to operations carried out on the dying. Each of these areas shows remarkable parallels to the present-day medical and ethical discussion.Conclusion: The value of such considerations does not lie in the uncritical application of experience gained in the past, but rather in a growing awareness of the wide spectrum of parameters and in a deeper understanding of the various possible approaches to a given situation. The tradition in the Western world of carrying out a delivery on a dead mother, in spite of the conflict of interests between the mother and the foetus, is of particular importance. In practice, the many non-medical factors should be taken more into consideration, with special emphasis being placed on the informed consent of the relatives. (shrink)

We present the case of a 36-year-old woman who has experienced three lost pregnancies; during the most recent loss, a full term pregnancy, she almost died from complications of placental abruption. She is now completing the 34th week of gestation and is experiencing symptoms similar to those under which she lost the previous pregnancy. Despite a lack of specific medical indications, the patient and her husband firmly but politely request that the attending obstetrician/perinatologist perform an immediate cesarean section in order (...) to alleviate the couple’s anxiety about possibly never having a family. Discussing the case are an experienced perinatologist, a neonatologist, a regional perinatal center coordinator, and a clinical ethicist. (shrink)

If one were to find a date for the games put on by Pompey to celebrate the opening of his theatre in 55 B.C., it would be possible to assign a more precise date to the delivery of Cicero's speech in Pisonem than seems to have been done so far. Asconius states quite firmly that the in Pisonem was delivered in the second consulship of Pompey and Crassus, a few days before the lavish games celebrating the opening of Pompey's (...) theatre. Asconius rejects a counter-view that the speech was delivered late in the following year. (shrink)

ABSTRACTAlthough dominant discourses of various kinds are frequently reproduced on talk radio, the fundamentally collaborative nature of the medium also means that it is able to serve as a channel...

Background The convergence of neuroscience, genomics, and data science holds promise to unveil the neurobiology of psychosis and to produce new ways of preventing, diagnosing, and treating psychotic illness. Yet, moral challenges arise in neurobiological research and in the clinical translation of research findings. This article investigates the views of relevant actors in mental health on the moral challenges of accessing neurobiological information in the context of psychosis. Methods Semi-structured individual interviews with two groups: researchers employed in the National Health (...) Service (NHS) or a university in England (n = 14), and mental health professionals employed in NHS mental health services (n = 14). This article compares results in the two groups (total n = 28). Results This article presents findings around three conceptual areas: (1) research ethics as mostly unproblematic, (2) psychosis, neurobiological information, and mental health care, and (3) identity, relationships, and the future. These areas are drawn from the themes and topics that emerged in the interviews across the two groups of participants. Researchers and health professionals provided similar accounts of the moral challenges of accessing—which includes acquisition, communication, and use of—neurobiological information in the context of psychosis. Acquiring neurobiological information was perceived as mostly unproblematic, provided ethical safeguards are put in place. Conversely, participants argued that substantive moral challenges arise from how neurobiological information is delivered—that is, communicated and used—in research and in clinical care. Neurobiological information was seen as a powerful tool in the process through which individuals define their identity and establish personal and clinical goals. The pervasiveness of this narrative tool may influence researchers and health professionals’ perception of ethical principles and moral obligations. Conclusions This study suggests that the moral challenges that arise from accessing neurobiological information in the context of psychosis go beyond traditional research and clinical ethics concerns. Reflecting on how accessing neurobiological information can influence individual self-narratives will be vital to ensure the ethical translation of neuroscience and genomics into mental health. Trial registration The study did not involve a health care intervention on human participants. It was retrospectively registered on 11 July 2018, registration number: researchregistry4255. (shrink)

This article will examine the Catholic concept of global justice within a health care framework as it relates to women's needs for delivery doctors in the developing world and women's demands for assisted reproduction in the developed world. I will first discuss justice as a theory, situating it within Catholic social teachings. The Catholic perspective on global justice in health care demands that everyone have access to basic needs before elective treatments are offered to the wealthy. After exploring specific (...) discrepancies in global health care justice, I will point to the need for delivery doctors in the developing world to provide basic assistance to women who hazard many pregnancies as a priority before offering assisted reproduction to women in the developed world. The wide disparities between maternal health in the developing world and elective fertility treatments in the developed world are clearly unjust within Catholic social teachings. I conclude this article by offering policy suggestions for moving closer to health care justice via doctor distribution. (shrink)