Fabi and Goldberg raised important considerations regarding both research and funding priorities in the field of bioethics and, in particular, the field’s misalignment with social justice. W...

Preterm birth is defined as delivery occurring before 37 weeks gestation.1 Infants born prematurely have increased risks of morbidity and mortality throughout life, especially during the first year. These risks increase as the gestational age at birth decreases.2 Additionally, there are significant racial and ethnic differences in preterm birth rates. In 2022, the rate of preterm birth among non-Hispanic black women was approximately 50% higher than that observed in non-Hispanic white women.1 The outcomes for these infants are also disparate–preterm birth (...) and low birth weight are the second-leading causes of infant mortality (deaths before 1 year of age). Notably, among preterm neonates, infants born to non-Hispanic black women have a mortality rate more than double that of infants born to non-Hispanic white mothers.3 Importantly, there is a small but significant group of neonates that can be classified as severely premature (those born <28 weeks). Infants born before 28 weeks have varied and uncertain outcomes. While this group accounts for only 0.4% of preterm births, it also accounts for 40% of deaths among preterm neonates.4 As noted by Romanis and Adkins, the advent of artificial amnion and placenta technology (AAPT) holds promise for its potential to address the physiologic complications and mortality risks of extreme prematurity by introducing amniotic substitutes that mimic in vivo placental oxygenation and substrate delivery. In contrast …. (shrink)

In the wake of the Supreme Court Decision, Dobbs v. Jackson Women’s Health Organization, Minkoff, Vullikanti, and Marshall (2024) argue that the unraveling of the constitutional right to abortion t...

The field of bioethics is calling for a new generation of scholars equipped with the normative, empirical, and practical knowledge and expertise to prioritize equity concerns largely underrepresent...

In “The Bioethics of Environmental Injustice: Ethical, Legal, and Clinical Implications of Unhealthy Environments,” Ray and Cooper (2024) initiate needed discourse on environmental justice and the...

The debate over how to best guide HIV-infected mothers in resource-poor settings on infant feeding is more than two decades old. Globally, breastfeeding is responsible for approximately 300,000 HIV infections per year, while at the same time, UNICEF estimates that not breastfeeding (formula feeding with contaminated water) is responsible for 1.5 million child deaths per year. The largest burden of these infections and deaths occur in Sub-Saharan Africa. Using this region as an example of the burden faced more generally in (...) other resource-poor settings, we contrast the evolution of the clinical standard of care for infant feeding with HIV-infected mothers in high-income countries to the current international clinical guidelines for HIV-infected mothers and infant feeding in resource-poor settings. While the international guidelines of exclusive breastfeeding for a 6-month period seem to offer the least-worst strategy for reducing mother-to-child transmission of HIV during infancy while conferring some immunity through breastfeeding post-6 months, we argue that the impact of the policy on mothers and healthcare workers on the ground is not well understood. The harm reduction approach on the level of health policy translates into a complicated, painful moral dilemma for HIV-positive mothers and those offering them guidance on infant feeding. We argue that the underlying socio-economic disparities that continue to fuel the need for a harm reduction policy on infant feeding and the harm to women and children justify: (1) that higher priority be given to solving the infant feeding dilemma with improved data on safe feeding alternatives, and (2) support of innovative, community-driven solutions that address the particular economic and cultural challenges that continue to result in HIV-transmission to children within these communities. (shrink)