With the rise of the “humanitarian drone” in recent years, drones have become one of the most controversial public interest technologies that have gained increasing media attention. It is worth noting that, although there is a perception in the aid sector that drones hold the promise to reinvent the health supply logistics, to date, routine drone delivery is still relatively new and largely unproven. This paper presents a recent field study conducted in 2019, where drones were deployed in (...) Malawi to help address the last mile challenge in medical supply delivery, and where a noticeable mentality of “killing two birds with one stone” around the attempt of using drones in resource-poor settings is observed. The objective of the paper is to shed light, through a real-world case study and from the ethical perspective, on the impacts of implementing such a systemic change in the existing health supply chain systems. As conclusion, a call for more reflexive approaches for the critical examination, as well as more structured guidance for the responsible evaluation, of medical cargo drones is raised. (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)

Domino's Pizza is testing “Domicopter” drones to deliver pizzas, which will compete with Taco Bell's “Tacocopter” drones. Not to be outdone, Amazon is working on an army of delivery drones that will cut out the postal service. In Denmark, farmers use drones to inspect fields for the appearance of harmful weeds, which reduces herbicide use as the drones directly apply pesticides only where it is needed. Environmentalists send drones into glacial caves or into deep waters, gathering data that would be (...) too dangerous or expensive for human scientists to procure. Federal Express dreams of pilotless aerial and terrestrial drones that will transport goods more cheaply, reliably, and safely than vehicles operated by humans. Human rights activists deploy drones over conflict zones, intelligently searching for and documenting abuses for both rhetorical and legal purposes. Aid agencies send unmanned drones to villages deep in jungles or behind enemy lines, maneuvering hazardous terrain to bring food and supplies to endangered populations. Medical researchers are experimenting with injecting drone blood cells into humans that can mimic good cholesterol carriers or identify and neutralize cancerous cells. Parents in Vermont are using flying drones to accompany children to school, giving a whole new meaning to helicopter parenting. And Pilobolus, a New York dance company, has choreographed a dance in which drones and humans engage each other in the most human of acts: the creation of art. (shrink)

The use of drones (or unmanned aerial vehicles, UVAs) in humanitarian action has emerged rapidly in the last decade and continues to expand. These so-called ‘humanitarian drones’ represent the first wave of robotics applied in the humanitarian and development contexts, providing critical information through mapping of crisis-affected areas and timely delivery of aid supplies to populations in need. Alongside these emergent uses of drones in the aid sector, debates have arisen about potential risks and challenges, presenting diverse perspectives on the (...) ethical, legal, and social implications of humanitarian drones. Guided by the methodology introduced by Arksey and O’Malley, this scoping review offers an assessment of the ethical considerations discussed in the academic and gray literature based on a screening of 1,188 articles, from which we selected and analyzed 47 articles. In particular, we used a hybrid approach of qualitative content analysis, along with quantitative landscape mapping, to inductively develop a typology of ethical considerations associated with humanitarian drones. The results yielded 11 key areas of concern: (1) minimizing harm, (2) maximizing welfare, (3) substantive justice, (4) procedural justice, (5) respect for individuals, (6) respect for communities, (7) regulatory gaps, (8) regulatory dysfunction, (9) perceptions of humanitarian aid and organizations, (10) relations between humanitarian organizations and industry, and (11) the identity of humanitarian aid providers and organizations. Our findings illuminate topics that have been the focus of extensive attention (such as minimizing risks of harm and protecting privacy), traces the evolution of this discussion over time (i.e., an initial focus on mapping drones and the distinction of humanitarian from military use, toward the ethics of cargo drones carrying healthcare supplies and samples), and points to areas that have received less consideration (e.g., whether sustainability and shared benefits will be compromised if private companies’ interest in humanitarian drones wanes once new markets open up). The review can thus help to situate and guide further analysis of drone use in humanitarian settings. (shrink)

The current humanitarian use of drones is focused on two applications: disaster mapping and medical supply delivery. In response to the growing interest in drone deployment in the aid sector, we sought to develop a resource to support value sensitivity in humanitarian drone activities. Following a bottom-up approach encompassing a comprehensive literature review, two empirical studies, a review of guidance documents, and consultations with experts, this work illuminates the nature and scope of ethical challenges encountered by humanitarian (...) organizations embarking upon innovation programmes. The Framework for the Ethics Assessment of Humanitarian Drones (FEAHD) identifies five values and five key questions related to ethical considerations along the decision chain of humanitarian drone activities. It fills a gap between high-level, principle-based guidance related to humanitarian innovation, and detailed operation-oriented checklists for projects involving the use of drones. In this way, the FEAHD contributes to support value sensitivity in the humanitarian use of drones. (shrink)

The current humanitarian use of drones is focused on two applications: disaster mapping and medical supply delivery. In response to the growing interest in drone deployment in the aid sector, we sought to develop a resource to support value sensitivity in humanitarian drone activities. Following a bottom-up approach encompassing a comprehensive literature review, two empirical studies, a review of guidance documents, and consultations with experts, this work illuminates the nature and scope of ethical challenges encountered by humanitarian (...) organizations embarking upon innovation programmes. The Framework for the Ethics Assessment of Humanitarian Drones (FEAHD) identifies five values and five key questions related to ethical considerations along the decision chain of humanitarian drone activities. It fills a gap between high-level, principle-based guidance related to humanitarian innovation, and detailed operation-oriented checklists for projects involving the use of drones. In this way, the FEAHD contributes to support value sensitivity in the humanitarian use of drones. (shrink)

RESUMEN La formación de profesionales competentes y comprometidos con el ideal de justicia social y solidaridad humana es un reto para las universidades médicas en Cuba. El protagonismo estudiantil en este contexto contribuye a formar jóvenes autodeterminados, críticos, reflexivos, que se hagan cargo de su desarrollo profesional y participen de forma creadora en la transformación de la sociedad. Se realizó una investigación cualitativa en la Universidad de Ciencias Médicas de Camagüey, con el objetivo de valorar la visión que tienen (...) los líderes estudiantiles sobre el protagonismo estudiantil, los factores que lo limitan y acciones para perfeccionarlo. Se utilizaron las técnicas entrevista estructurada, entrevista grupal y observación participante a una muestra de once dirigentes estudiantiles. Se logró identificar que los dirigentes estudiantiles tienen una visión acertada sobre el protagonismo estudiantil y señalan factores que limitan el protagonismo, asociados a los propios estudiantes, los profesores, las autoridades universitarias y la institución. ABSTARCT The formation of competent and committed professionals with the ideal of social justice and human solidarity is a challenge for the medical universities in Cuba. The student-leading role in this context helps to form self-determined, critical, reflective young people, who take charge of his professional development and take part of creative form in the transformation of the society. A qualitative investigation was carried out in the University of Medical Sciences, with the objective to value the vision that the student leaders have on the student-leading role, the factors that limit it and actions to perfect it. There used the techniques structured interview, group interview and taking part observation to a sample of eleven student leaders. It was identified that the student leaders have an appropriate vision on the student-leading role and indicated factors that limit the leading role, associated with the proper students, the teachers, the university authorities and the institution. (shrink)

Personal data protection is an ethical issue. In this study we analyzed how research ethics committees (RECs) and data protection officers (DPOs) handle personal data protection issues in research protocols. We conducted a mixed-methods study. We included heads (or delegated representatives) of RECs and DPOs from universities and public research institutes in Croatia. The participants provided information about data protection issues in research and their mutual collaboration on those issues through structured interviews that contained closed and open-ended questions. Qualitative description (...) was used to analyze open-ended questions. The results showed that 55% of the REC representatives were not aware who was DPO in their institution. Among RECs, 65% never contacted the DPO. There were 61% of RECs who reported that they received no training from the organization on personal data protection. When asked about barriers to personal data protection in their institutions, 26% of REC members highlighted the lack of a clear protocol for assessing personal data protection issues, while 30% of DPOs mentioned lack of knowledge among researchers about personal data. In conclusion, we found that when it came to protecting personal data in research protocols, RECs and DPOs hardly ever worked together. When developing future personal data protection policies for academic and scientific research institutions, it is essential that RECs and DPOs should collaborate and both continue to expand/update their knowledge on personal data protection procedures. (shrink)

We write in response to the original article by Rennie and Rudland published in the April 2003 edition of this journal.1 Current and former Dundee Medical School students are concerned at the media misinterpretation of the study and the consequences that this branding of “dishonesty” will have on Dundee Medical School’s reputation and also on individuals embarking on their ….

This code of practice for health professionals was prepared by a multi-professional group and reflects good clinical practice in encouraging dialogue about individuals' wishes concerning their future treatment. It has a broad practical approach, considers a range of advance statements, advises of dangers and benefits of making treatment decisions in advance and combines annotated code of practice with a quick pull out guide for easy reference.

Summary Principles Timely support for patients and people close to them, and effective, sensitive communication are essential. Decisions must be based on the individual patient's circumstances and reviewed regularly. Sensitive advance discussion should always be encouraged, but not forced. Information about CPR and the chances of a successful outcome needs to be realistic. Practical matters Information about CPR policies should be displayed for patients and staff. Leaflets should be available for patients and people close to them explaining about CPR, how (...) decisions are made and their involvement in decisions. Decisions about attempting CPR must be communicated effectively to relevant health professionals. In emergencies If no advance decision has been made or is known, CPR should be attempted unless: the patient has refused CPR; the patient is clearly in the terminal phase of illness; or the burdens of the treatment outweigh the benefits. Advance decision making Competent patients should be involved in discussions about attempting CPR unless they indicate that they do not want to be. Where patients lack competence to participate, people close to them can be helpful in reflecting their views. Legal issues Patients' rights under the Human Rights Act must be taken into account in decision making. Neither patients nor relatives can demand treatment which the health care team judges to be inappropriate, but all efforts will be made to accommodate wishes and preferences. In England, Wales and Northern Ireland relatives and people close to the patient are not entitled in law to take health care decisions for the patient. In Scotland, adults may appoint a health care proxy to give consent to medical treatment. Health professionals need to be aware of the law in relation to decision making for children and young people.IntroductionWhy policies are neededCardiopulmonary resuscitation can be attempted on any person whose cardiac or respiratory functions cease. Failure of these functions is part of dying and thus …. (shrink)

This article presents an analysis of contractual relations in sport from the standpoint of the Croatian legislative system. Due to the complexity of the subject matter, the author considers only a small fragment of it - the significance and the role of sport in Croatian society and the law of contracts „as a cornerstone on which „sports law“ has been built and which is of primary importance in most areas where there is an interface between sport and the law, irrespective (...) of whether the sport is being played at an elite level or at a more humble one“. Bearing in mind the limited extent of this article, the autor tries to provide some clarifications and some guidance on how to deal with the designation and the determination of the applicable law for contracts in the sporting context. Considering that there are different legal regimes which may come into play with regard to the designation of the law applicable to contracts in the sporting context, the author first presents the determination of the applicable law according to the Rome I Regulation and then according to the Croatian Arbitration Act, Swiss Private International Law Act and the CAS Code of Sports-related Arbitration, as the most common in sports practice. Then, the author deals with contracts concluded with minor athletes and the determination of the law applicable to some preliminary questions. Finally, the author presents her perception of the problems encountered and some suggestions for the improvement of the existing legal framework. (shrink)

1. Aim of the guidelines2. Principles of good practice3. Circumcision for medical purposes4. Non-therapeutic circumcision 4.1. The law 4.1.1. Summary: the law 4.2. Consent and refusal 4.2.1. Children’s own consent 4.2.2. Parents’ consent 4.2.3. Summary: consent and refusal 4.3. Best interests 4.3.1. Summary: best interests 4.4. Health issues 4.5. Standards 4.6. Facilities 4.7. Charging patients 4.8. Conscientious objection5. Useful addresses.

Zemyarska MS. Is it ethical to provide IVF add-ons when there is no evidence of a benefit if the patient requests it? J Med Ethics 2019;45:346–50. doi: 10.1136/medethics-2018-104983. The Acknowledgements section of ….

Savulescu J. Is current practice around late termination of pregnancy eugenic and discriminatory? Maternal interests and abortion. J Med Ethics 2001;27:165–71. Lachlan de Crespigny contributed in a major way to the conceptualisation, design, administration of surveys, ….

Dheensa S, Fenwick A, Lucassen A.‘Is this knowledge mine ….

Now I know why so many stories have been written with the theme: “everything changed in one moment.” More than 1,000 days have come and gone, and I still remember one Sunday morning and still follow and feel the effects of one decision.

Dubin S, Lane M, Morrison S, et al. Medically assisted gender affirmation: when children and parents disagree. ….

Bowman-Smart et al. (2023) argue for a framework to examine the ethical issues associated with genetic screening for non-medical traits in the context of noninvasive prenatal testing (NIPT). Such s...

Fundamental questions in value sensitive design include whether and how high-tech products/artefacts could embody values and ethical ideals, and how plural and incommensurable values of ethical and social importance could be chosen rationally and objectively at a collective level. By using a humanitarian cargo drone study as a starting point, this paper tackles the challenges that VSD’s lack of commitment to a specific ethical theory generates in practical applications. Besides, it highlights how mainstream ethical approaches usually related to (...) VSD are incapable of solving main ethical dilemmas raised by technological design for well-being in democratic settings. Accordingly, it is argued that VSD’s ethical-democratic import would substantially be enhanced by the espousal of a procedural ethics stance and the deliberative approach to value and welfare entailed by Amartya Sen’s capability approach. Differently from rival ethical–political theories, its normative and meta-ethical foundations better handle human diversity, value-goal pluralism, conflicting vested interests as well as the epistemic-moral disagreements typical of contemporary complex democracies. Particularly, Sen’s capability approach procedural-deliberative tenets result in an “objective-impartial” choice procedure selecting a “hierarchy” of plural incommensurable values and rational goals thus, suitable to validate an applied science such as welfare-oriented technological design in concrete social environments. Conclusions suggest that refining VSD with a capability-based procedural approach to ethics fosters the concern for democracy and social justice while preserving vital scientific-technical standards. Major advantages are at an applied level to delivering ethically and socially justified, but yet highly functional technologies and high-tech products/artefacts. (shrink)

*The views expressed are the author's own. This article should not be construed as representing policies of the American Medical Association.

*Disclaimer: The views expressed are the author's and should not be ascribed to the American Medical Association.

Ost S. Drs Bramhall and Bawa-Garba and the rightful domain of the criminal ….

Sheldon S, Lord J. Guest editorial: Care not criminalisation; reform of British abortion law is ….

Monrad JT. Ethical considerations for epidemic vaccine trials. J Med Ethics 2020;46:465–9. doi:10.1136/medethics-2020-106235 This ….

Douglas T. Going above and beneath the call ….

Wilkinson D. What has philosophy got to do with it? ….

Surveillance is a core function of all public health systems. Responses to the COVID-19 pandemic have deployed traditional public health surveillance responses, such as contact tracing and quarantine, and extended these responses with the use of varied technologies, such as the use of smartphone location data, data networks, ankle bracelets, drones, and big data analysis. Applying Foucault’s (1979) notion of the panopticon, with its twin focus on surveillance and self-regulation, as the preeminent form of social control in modern societies, we (...) examine the increasing levels of surveillance enacted during this pandemic and how people have participated in, and extended, this surveillance, self-regulation, and social control through the use of digital media. Consideration is given to how such surveillance may serve public health needs and/or political interests and whether the rapid deployment of these extensive surveillance mechanisms risks normalizing these measures so that they become more acceptable and then entrenched post-COVID-19. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Explode and Die!A Fat Woman’s Perspective on Prenatal Care and the Fat Panic EpidemicJennifer HansenClassifying obesity as a disease provides more ammunition for the “war on obesity.” I gather that this is supposed to be a good thing. The problem is that obesity isn’t a germ or a crime; it’s a word applied to a particular kind of body—and thus to the person inhabiting it.From a fat person’s perspective, (...) the “war on obesity” is a war on fat people. It’s a license to bully, shame, and ostracize fat people and deny us employment, medical care, and even ordinary family life because we don’t look right. Fat people, proclaimed by medical authority to be the enemy and identifiable on sight as outsiders, are made into targets for all kinds of free–floating anger. For example, I am apparently sucking away people’s tax dollars via my fat, and it’s also my fault that men expecting to fantasize about every woman they see on the street encounter my distasteful fatness instead. But no matter how many times we get told that we are wrong just for existing, we go on existing, in public even. How dare we? The answer, obviously, is to keep at us. If we would just admit that we have no right to exist, then we would all either vanish or become socially acceptably thin, and then the whole world would be unicorns and butterflies and everyone would be rich and nobody would get old. Or something like that. If obesity is a disease, then phrenology is a science.Of course, we get a lot of well–meaning flak along with the bullying; after all, concentrating on weight loss can only be good for us, because fat people are always about to explode and die. This assumption has definitely affected my relationship with the only medical practice I can reach that’s in my network. During the 20–plus years since I became visibly obese, I have gotten used to the constant drone of “You’re fat, you’re fat, you’re about to explode and die, we don’t care about what you actually came in for because it’s vitally important that we bug you yet again about your pants size,” but some things can still shock me. For example, during all three of my pregnancies, I never had a result that was even borderline for gestational diabetes (GD). And yet, some time after my last baby was born, someone wrote “HISTORY OF GESTATIONAL DIABETES” in my file. I first heard about it during my annual checkup, when the doctor referred to it when talking about my increased risk of Type 2 diabetes due to age (unavoidable), my first–ever non–whitecoat–syndrome borderline blood pressure (BP) reading (taken with a standard cuff, gee how could it possibly have been inaccurate), and GD (gosh, I felt so safe and supported at this fine reality–based practice). And of course my weight.Whoever wrote that felt free to make things up because I’m fat. To repeat, somebody with access to my file at my only source for affordable health care felt free to write things in it that were completely contradicted by the facts just a few sheets below. There’s no need to fact–check your assumptions when you can tell by looking at her that she’s F–A–T, and everybody knows what they are. They’ll explode and die, every last one of them. Better medicate them now before they inevitably break down!Speaking of which, there’s a particular OB at the practice who I’ll call Doctor Eeyore. At every appointment, Doctor Eeyore would take measurements, stare, and say, “Hmm … tch.” If I asked him to tell me what he had found, he would say, “Too big,” or, “Too small,” or indicate some other inadequacy in his glum, word–miserly way. He only bothered to produce complete sentences when he enthusiastically told me that I would die if I didn’t give birth with an IV in place to administer the life–saving drugs for my inevitable cardiac event... (shrink)

In a long and many-sided career, William Hasledine Pepys contributed significantly to the advancement of the chemical and physical sciences during the first half of the nineteenth century. As an original investigator he determined, in collaboration with William Allen, the composition of carbon dioxide, and the density of ammonia, and elucidated the chemical phenomena of respiration in man, animals, and plants. The success of these researches was largely due to the use of ingenious apparatus of his own invention and design. (...) In the field of experimental physics, he investigated several aspects of the recently discovered Voltaic electricity: his 'Voltaic coil', consisting of only two plates, but of very large dimensions, was particularly suited for investigating electromagnetic phenomena and was so used in Davy's researches. Pepys was one of the co-founders of the Mineralogical and Geological Societies, and was elected a Fellow of the Royal Society in 1808. As a prominent member of both the Royal and London Institutions, he held honorary office as Manager and Vice-President, contributing materially to the direction of the affairs of these bodies. Pepys was a friend of Humphry Davy and was acquainted with nearly all the leading scientists and medical men of the day. At the same time, he superintended a notable manufacture of surgical instruments in the City, and promoted by his active directorship the affairs of two public companies, both pioneers in their technological fields, namely the Imperial Continental Gas Association, which was active in introducing the new gas illumination to cities and towns across Europe, and the General Steam Navigation Company, which first maintained a regular passenger and cargo service to Continental ports by the exclusive use of steam-propelled vessels. Pepys' advice in scientific and technical matters was widely sought and freely given; he retained his mental powers to the end of his long life, fulfilling his professional commitments until a few days before his death. (shrink)

In this chapter, we consider the plausibility and consequences of the use of the term “honest errors” to describe the accidental killings of civilians resulting from the US military’s drone campaigns in Iraq, Syria, Afghanistan, and elsewhere. We argue that the narrative of “honest errors” unjustifiably excuses those involved in these killings from moral culpability, and reinforces long-standing, pernicious assumptions about the moral superiority of the US military and the inevitability of civilian deaths in combat. Furthermore, we maintain that, (...) given the knowledge-distorting practices within the US military’s organizational structure, few if any civilian deaths from drone strikes meet the criteria of a genuinely morally excusing “honest mistake”. Instead, these accidental killings often reflect objectionable attitudes of relative disregard for the safety of civilians. These attitudes are, we argue, sufficient to warrant the attribution of blame and moral responsibility, both with respect to certain individual actions and with respect to the US military as an institution. In light of this, we propose incorporating a Principle of the Moral Equality of Non-combatants into military assessments of what counts as “acceptable risk” to civilians. This would go some way, we argue, to redressing the ongoing injustice inflicted on the victims of civilian killings by the failure of the US military and US political leadership to take moral responsibility for unjustified civilian deaths. (shrink)

ABSTRACTThis article explores the relationship between the operation of combat drones and the martial virtue courage. The article proceeds in three parts. Part one develops a brief account of virtue generally, and the martial virtue courage in particular. Part two discusses why critics suggest that drone operation does not fit the orthodox conceptualization of courage and, in some instances, even erodes the virtue. Part three explores how these criticisms are flawed. This section of the paper goes on to argue (...) that the criticisms are predicated on a twofold misunderstanding. The first involves improperly truncated conceptualizations of courage, which are, in part, predicated upon a narrow definition of risk. From this narrow definition of risk springs the conclusion that drone operation must be riskless. The second misunderstanding follows from the first and involves the failure to grasp properly how courage can be cultivated and required in drone operation. The paper concludes with a discussion of how, pr.. (shrink)

The article reflects the discourses surrounding the military use of drones in the context of their employment in Afghanistan and Waziristan in the last two decades with a special emphasis on its necropolitical dimensions. It does so by first summarizing different critical accounts of a single well documented case in Afghanistan, underscoring historical continuities between drone warfare, state terror and air power. Second, the article puts a special emphasis on relations on the ground such as ambiguous legal constructions enabling (...) the use of lethal force, and the weaponization of Pashtun culture for the purposes of different governments. (shrink)

This article addresses the problematic perspectives of drone culture. In critiquing focus on the drone’s apparent ‘autonomy’, it argues that such devices function as part of a socio-technical network. They are relational parts of human–machine interaction that, in our changing geopolitical realities, have a powerful influence on politics, reputation and warfare. Drawing on Žižek’s conception of parallax, the article stresses the importance of culture and perception in forming the role of the drone in widening power asymmetries. It (...) examines how perceptions of autonomy are evoked by drones, to claim that this misperception is a smokescreen that obscures the relational socio-technical realities of the drone. The article therefore argues that a more critical culture of the drone emerges by shifting the focus and perception from autonomy to anonymity. This allows us to engage more fully with the distributed agency and decision-making that define how drones are developed and deployed. Rather than focusing on the drone as a singular, fetishised, technical object, a relational approach to the drone assemblage is proposed that highlights the competing human interests that define and resist drones in global politics and culture. (shrink)