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Background: Infant feeding interventions that promote and support breastfeeding are considered important contributions to global public health. As these interventions often target private settings (e.g., individuals’ homes) and involve vulnerable populations (e.g., pregnant women, infants, and underprivileged families), a keen awareness of ethical issues is crucial. Research Aim: The purpose of this scoping review was to capture the key elements of the current ethical discourse regarding breastfeeding and lactation interventions. Method: A scoping review was conducted using Arksey and O’Malley’s (2005) methodology to identify the ethical issues of breastfeeding and lactation interventions as they are reflected in the scholarly literature published between January 1990 and October 2022. Abstracts ( N = 3715) from PubMed, ScienceDirect, JSTOR and the Cochrane Database of Systematic Reviews were screened. The final sample consisted of 26 publications. Results: The recurring ethical issues identified in these studies were: the normative assumptions of motherhood; maternal autonomy and informed choice; information disclosure, balancing risks and benefits, and counseling practices; stigma and social context; ethics of health communication in breastfeeding campaigns; and the ethical acceptability of financial incentives in breastfeeding interventions. Conclusion: This review illustrated that, while a wide range of ethical arguments were examined, the emphasis has been primarily on accounting for mothers’ experiences and lactating persons’ choices, as well as achieving public health objectives relating to infant nutrition in breastfeeding interventions. To effectively and ethically implement breastfeeding and lactation interventions, we must consider the social, economic, and cultural contexts in which they occur. One key learning identified was that women’s experiences were missing in these interventions and, in response, we suggest moving beyond the dichotomous approach o

The present review analyses the implications of the best interests of the child principle, which is one of the most widely discussed principles of medical ethics and human rights, for paediatric healthcare. As a starting point, it presents the interpretation of the best interests principle by the United Nations Committee on the Rights of the Child. On this basis, it points out possible fields of application of the best interests principle with regard to paediatric healthcare and discusses the potential difficulties in the application of the best interests principle. Based on this, it illustrates the implications of the best interests principle for paediatric healthcare through four case studies, which look at ethical dilemmas in paediatric gynaecology, end-of-life care, HIV care and genetic testing. Conclusion: The best interests principle requires action, inter alia, by health policymakers, professional associations, hospital managers and medical teams to ensure children receive the best possible healthcare. Whilst the best interests principle does not provide a conclusive solution to all ethical dilemmas in paediatric healthcare (as illustrated by the case studies), it provides children, medical teams, parents and families, and clinical ethicists with an indispensable framework for health care centred on the rights of the child. What is Known: • The best interests principle is one of the most widely discussed principles of medical ethics and human rights and one of the four general principles of the Convention on the Rights of the Child. What is New: • The present review discusses possible fields of application and potential difficulties of the best interests principle with regard to paediatric healthcare. • Based on this, it illustrates the implications of the best interests principle for paediatric healthcare through four case studies, which look at ethical dilemmas in paediatric gynaecology, end-of-life care, HIV care and genetic testing. Keywords: Best interes

The COVID-19 pandemic has been a challenging time for different communities, including the LGBTQI+ (lesbian, gay, bisexual, transgender, queer, intersex, and other gender identities and sexual orientations) community, and has sharpened health inequalities already present before the pandemic. In his report to the United Nations General Assembly of 28 July 2020, the United Nations Independent Expert on protection against violence and discrimination based on sexual orientation and gender identity, Victor Madrigal-Borloz, provided a detailed overview of ways in which the COVID-19 pandemic has affected the LGBTQI+ community [1]. Stay-at-home policies, quarantine and isolation, and social stress have severely increased their risk of victimization, particularly in the case of LGBTQI+ people living with unsupportive family members. In several countries, including, e.g., the United States, Turkey, Georgia, Ghana and Malaysia, powerful religious and political leaders have blamed LGBTQI+ persons for the COVID-19 pandemic, which has led to a sharp rise in (online) hate speech. In Uganda, lockdown policies have been instrumentalised for a crackdown on the LGBTQI+ community [1]. The mental health of many LGBTQI+ persons has also significantly deteriorated in many countries; in the US, for example, 50.0% of LGBTQI+ adult respondents in the US Census Bureau’s March – May 2022 Household Pulse Survey reported symptoms of anxiety (compared to 24.3% of non-LGBTQI+ adults) and 41.6% symptoms of depression (compared to 19.4% of non-LGBTQI+ adults) [2].

Sanctions are increasingly used by national states and the international community to put economic and political pressure on target countries, with the aim of effecting a shift in foreign or internal policies. In this paper, we argue that sanctions should never be imposed on healthcare products—diagnostic, curative or preventive—or on any other good or service that can be reasonably expected to entail direct negative consequences on access to healthcare in the sanctioned state. In addition, we propose the establishment of a supranational task force to review and monitor sanctions to ensure they do not violate the right to health, or to mandate existing organisations to monitor the effects sanctions have on healthcare systems. We discuss these issues considering key ethical and human rights aspects, including justice, vulnerability, proportionality and responsibility. We discuss how responsibility should be shared between states or organisations imposing the sanctions, and states targeted by sanctions. Sanctioned states should make efforts to mitigate effects of economic sanctions by prioritising spending in the interest of their citizens’ health.

The present commentary analyses and discusses the Fjölnisdóttir et al. v. Iceland decision of the European Court of Human Rights (ECtHR) of 18 May 2021. The case concerned an Icelandic couple who had been recognised as the legal parents of a child born by a surrogate mother in California. In contrast to most other surrogacy cases decided by the ECtHR, however, the child had no biological link to either of the intended parents. The ECtHR thus found that a ruling of the Supreme Court of Iceland which had rejected the recognition of the legal parenthood of the intended parents under Icelandic law had not violated Art. 8 of the European Convention on Human Rights, despite the fact that joint adoption by the intended parents was not possible in this case. The present commentary argues that this decision exaggerates the importance of the biological link, creating injustices at the expense of the child concerned. In conclusion, the commentary calls for a more consistent and holistic framework to protect the best interests of the child and to prevent abuses of transnational commercial surrogacy.

The Covid-19 pandemic has led to a health crisis of a scale unprecedented in post-war Europe. In response, a large amount of healthcare resources have been redirected to Covid-19 preventive measures, for instance population-wide vaccination campaigns, large-scale SARS-CoV-2 testing, and the large-scale distribution of protective equipment (e.g., N95 respirators) to high-risk groups and hospitals and nursing homes. Despite the importance of these measures in epidemiological and economic terms, health economists and medical ethicists have been relatively silent about the ethical rationales underlying the large-scale allocation of healthcare resources to these measures. The present paper seeks to encourage this debate by demonstrating how the resource allocation to Covid-19 preventive measures can be understood through the paradigm of the Rule of Rescue, without claiming that the Rule of Rescue is the sole rationale of resource allocation in the Covid-19 pandemic.