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This paper addresses the critiques based on trade-offs and normativity presented in response to our target article proposing the Public Health Emergency Risk and Crisis Communication (PHERCC) framework. These critiques highlight the ethical dilemmas in crisis communication, particularly the balance between promoting public autonomy through transparent information and the potential stigmatization of specific population groups, as illustrated by the discussion of the mpox outbreak among men who have sex with men. This critique underscores the inherent tension between communication effectiveness and autonomy versus fairness and equity. In response, our paper reiterates the adaptability of the PHERCC framework, emphasizing its capacity to tailor messages to diverse audiences, thereby reducing potential stigmatization and misinformation. Through community engagement and feedback integration, the PHERCC framework aims to optimize the effectiveness of communication strategies while addressing ethical concerns. Furthermore, by involving affected communities in the communication strategy from the onset, the framework seeks to minimize ethical trade-offs and enhance the acceptance and effectiveness of public health messages. [ABSTRACT FROM AUTHOR]

Risk and crisis communication (RCC) is a current ethical issue subject to controversy, mainly due to the tension between individual liberty (a core component of fairness) and effectiveness. In this paper we propose a consistent definition of the RCC process in public health emergencies (PHERCC), which comprises six key elements: evidence, initiator, channel, publics, message, and feedback. Based on these elements and on a detailed analysis of their role in PHERCC, we present an ethical framework to help design, govern and evaluate PHERCC strategies. The framework aims to facilitate RCC, incorporating effectiveness, autonomy, and fairness. It comprises five operational ethical principles: openness, transparency, inclusivity, understandability, and privacy. The resulting matrix helps understanding the interplay between the PHERCC process and the principles of the framework. The paper includes suggestions and recommendations for the implementation of the PHERCC matrix. [ABSTRACT FROM AUTHOR]

Conversational artificial intelligence (CAI) presents many opportunities in the psychotherapeutic landscape—such as therapeutic support for people with mental health problems and without access to care. The adoption of CAI poses many risks that need in-depth ethical scrutiny. The objective of this paper is to complement current research on the ethics of AI for mental health by proposing a holistic, ethical, and epistemic analysis of CAI adoption. First, we focus on the question of whether CAI is rather a tool or an agent. This question serves as a framework for the subsequent ethical analysis of CAI focusing on topics of (self-) knowledge, (self-)understanding, and relationships. Second, we propose further conceptual and ethical analysis regarding human-AI interaction and argue that CAI cannot be considered as an equal partner in a conversation as is the case with a human therapist. Instead, CAI's role in a conversation should be restricted to specific functions. [ABSTRACT FROM AUTHOR]

The medical profession contains five "spheres of morality": clinical care, clinical research, scientific knowledge, population health, and the market. These distinct sets of normative commitments require physicians to act in different ways depending on the ends of the activity in question. For example, a physician-scientist emphasizes patients' well-being in clinic, prioritizes the scientific method in lab, and seeks to maximize shareholder returns as a board member of a pharmaceutical firm. Physicians increasingly occupy multiple roles in healthcare and move between them frequently, creating the possibility of conflict between the ethical obligations of their various roles. This paper examines the entire moral landscape of medicine through the lens of role morality. It develops a novel framework that helps physicians recognize how their moral commitments depend on the nature and context of the situation, clarifies ethical conflicts that physicians face, and concludes with ideas for resolving these conflicts. [ABSTRACT FROM AUTHOR]

Increasing privacy concerns are arising from expanding use of aggregated personal information in health practices. Conversely, in light of the promising benefits of data driven healthcare, privacy is being frequently dismissed as outdated, costly and ultimately egotistical. This paper aims to review the theoretical framework on privacy in order to overcome the often simplistic debate between the primacy of individual or collective interests. As a result, it is argued that although privacy can be understood as freedom of personal choice in matters of sharing intimacy, it is foundational to both community belonging and to social and political organizations at large. Ethical decisions on the use of data analytics technologies in health practices should also take into account the social effects of violating privacy. [ABSTRACT FROM AUTHOR]

Patients who experience difficulty making medical decisions are often referred to as "ambivalent." However, the current lack of attention to the nuances between a cluster of phenomena that resemble ambivalence means that we are not always recognizing what is really going on with a patient. Importantly, different kinds of "ambivalence" may call for different approaches. In this paper, we present a taxonomy of ambivalence-related phenomena, provide normative analysis of some of the effects of—and common responses to—such mental states, and sketch some practical strategies for addressing ambivalence. In applying lessons from the philosophical literature and decision theory, our aim is to provide ethicists and clinicians with the tools to better understand and effectively intervene in cases of ambivalence. [ABSTRACT FROM AUTHOR]

Terminally ill patients in 10 states plus Washington, D.C. have the right to take prescribed medications to end their lives (medical aid in dying). But otherwise-eligible patients with neuromuscular disabilities (ALS and other illnesses) are excluded if they are physically unable to "self-administer" the medications without assistance. This exclusion is incompatible with disability rights laws that mandate assistance to provide equal access to health care. This contradiction between aid-in-dying laws and disability rights laws can force patients and clinicians into violating one or the other, potentially creating an underclass of patients denied medical care that is available to those with other (less physically disabling) terminal illnesses. The immediacy of this issue is demonstrated by a lawsuit in Federal court filed in August 2021, requesting assistance in self-administration for terminally ill patients with neuromuscular diseases. This paper discusses the background of this conflict, the ethical issues at the heart of the dilemma, and recommends potential remedies. [ABSTRACT FROM AUTHOR]

While the accumulation and increased circulation of genomic data have captured much attention over the past decade, privacy risks raised by the diversification and integration of omics have been largely overlooked. In this paper, we propose the outline of a framework for assessing privacy risks in multi-omic research and databases. Following a comparison of privacy risks associated with genomic and epigenomic data, we dissect ten privacy risk-impacting omic data properties that affect either the risk of re-identification of research participants, or the sensitivity of the information potentially conveyed by biological data. We then propose a three-step approach for the assessment of privacy risks in the multi-omic era. Thus, we lay grounds for a data property-based, 'pan-omic' approach that moves away from genetic exceptionalism. We conclude by inviting our peers to refine these theoretical foundations, put them to the test in their respective fields, and translate our approach into practical guidance. [ABSTRACT FROM AUTHOR]

This open peer commentary refers to the article "Toward a Framework for Assessing Privacy Risks in Multi-Omic Research and Databases," by Charles Dupras and Eline M. Bunnik, that was published within the issue. Topics discussed include artificial intelligence (AI) methodologies for analyzing biomedical data, human-like behavior of machines, and ethical concerns from the power of AI when applied to human tissue repositories.

The article focuses on the importance of including undocumented immigrants in research while ensuring their protection and confidentiality. Topics covered include the vulnerability of undocumented immigrants; the role of Institutional Review Boards (IRBs) in providing guidelines and support; and the responsibilities of researchers in conducting ethical and inclusive studies with this population.

The author argues against heroism and explains health care workers' duty to treat despite their risk of illness and death during an epidemic. Several principles commonly used to justify a duty to treat are considered including consent/implied consent, special training, oaths and codes, and reciprocity/social contract. The author refers to reciprocity/fairness principle and transactional ethics as the answer as to why health care workers risk their lives to provide essential services to society.

The article focuses on complete ectogenesis and associated concerns related to artificial womb technology (AWT). Topics discussed include AWT as a substitute for abortion, benefits of AWT to facilitate continued gestation and childbirth and consequences of policy designed to avoid abortion by substituting AWT.

The author discusses the article "Privacy and Health Practices in the Digital Age" by M. Pyrrho and colleagues which recognize a tendency to oversimplify privacy in health, portraying it as an inevitable conflict between individual and collective interests. Topics include the two distinct categories of collective interests according to Pyrrho and colleagues, the difficulty of making informed choices about personal data in the digital age, and an overview of data protection regulation in Europe.

The article presents the discussion on trauma-informed approach to formulating hospital system policies and demonstrating the approach through discharge planning policy. Topics include supporting the trauma-informed principles of collaboration, mutuality, empowerment, and voice; and hospital systems showing concern about rising numbers of patients and families resistant to proposed discharge plans.

The article presents the discussion on exploring patient ambivalence in the context of medical decision-making. Topics include misalignment of patient goals with treatment plans, feelings of distress in the health care team, and other harms; and efforts neglecting a major facet of human psychology contributing to situations of patient ambivalence.

The article presents the discussion on conceptual issue concerning ambivalence in medical decision-making. Topics include incurable neurodegenerative disease, surgery or chemo/radiation in the setting of a malignant brain tumor; and focusing on the inability for choosing an impossible situation ignoring the actual issue the individuals being confronting.

This open peer commentary refers to the article "Toward a Framework for Assessing Privacy Risks in Multi-Omic Research and Databases," by Charles Dupras and Eline M. Bunnik, that was published within the issue. Topics discussed include genomic exceptionalism, methylation and histone modification within epigenomics, and biology-intrusive and life-intrusive information.

This open peer commentary refers to the article "Toward a Framework for Assessing Privacy Risks in Multi-Omic Research and Databases," by Charles Dupras and Eline M. Bunnik, that was published within the issue. Topics discussed include normative approach of genetic exceptionalism, data security, and risk and discriminatory potential associated with epigenomic data in research.