Written by James Anderson
Published in Vol 6 Issue 1, 2026
Respect for patient autonomy is commonly associated with protecting persons from unwanted interference, yet clinical restraint can become ethically inadequate when patients are left to manage difficult choices without support that could preserve meaningful agency. This original normative–conceptual article examines the point at which respect for choice risks becoming clinical abandonment. It distinguishes formal decisional freedom from practically supported choice and argues that autonomy should
Written by Hans Müller
Published in Vol 6 Issue 1, 2026
Shared decision-making is commonly described as a collaborative clinical ideal, yet collaboration does not by itself determine who owns the responsibilities generated by a decision. In interprofessional care, patients, physicians, nurses, consultants, family members, and institutions may contribute different forms of knowledge, influence, authority, implementation work, and retrospective answerability. This philosophical analysis examines that unresolved ownership problem by treating the clinica
Written by Sofía Martínez
Published in Vol 6 Issue 1, 2026
Health-professions ethics education often emphasizes reasoning, judgment, and action after an ethical problem has already been recognized. Yet ethically consequential features of clinical situations may never become objects of deliberate reflection because they are overlooked, trivialized, normalized, or interpreted through a narrowed perspective. This conceptual-framework article proposes moral attention as an educational construct situated upstream of, but interacting with, moral reasoning and
Written by Kenji Tanaka
Published in Vol 6 Issue 1, 2026
Bedside decisions become ethically difficult when clinically defensible options implicate competing patient values, professional obligations, relationships, prognostic uncertainties, or institutional constraints. Clinical ethics offers multiple reasoning traditions and decision frameworks, yet these approaches differ in what they treat as morally salient and how they organize disagreement. Their relationship to the reasoning work clinicians perform in practice remains incompletely integrated. An
Written by João Silva
Published in Vol 6 Issue 1, 2026
Health-system scarcity becomes ethically acute when a clinically relevant option is not merely expensive in the abstract but unavailable to a particular patient at a particular moment. This article develops an original normative framework for bedside decisions under such constraint. It distinguishes scarcity from allocation, patient-level constraint, and moral abandonment, and argues that justified limits on what a system can provide do not automatically extinguish duties toward the patient whos
Written by Emma Wilson
Published in Vol 6 Issue 1, 2026
Moral distress is usually treated as a burden to be reduced through coping, resilience, or psychological support. That response can be appropriate, yet it may also individualize a problem whose ethically relevant causes lie partly in clinical routines, authority relations, resource constraints, and institutional decision structures. This conceptual–institutional article develops an alternative but deliberately limited account: moral distress can function as ethical intelligence. On this account,
Written by Mark Anderson
Published in Vol 6 Issue 1, 2026
Ethics education is widely expected to improve clinicians’ capacity to recognise, analyse, and respond to ethically difficult situations, yet educational success is often inferred from proximal outcomes such as knowledge, moral sensitivity, reasoning scores, or learner perceptions. Whether such changes alter professional behaviour, transfer into clinical decision-making, or persist within practice remains less certain. This systematic review examined ethics education across four prespecified dom
Written by Sara Al-Fahd
Published in Vol 6 Issue 1, 2026
Clinical uncertainty is often treated as an epistemic limitation to be reduced through further testing, consultation, prediction, or experience. Yet uncertainty also changes the ethical structure of clinical encounters because patients and clinicians must frequently make consequential choices before uncertainty can be eliminated. This normative article examines clinical uncertainty as an ethical condition and asks what obligations arise when diagnosis, prognosis, treatment effects, or the conseq
Written by Youssef Hariri
Published in Vol 6 Issue 1, 2026
Decision-making capacity is commonly treated as a threshold question: can this person make this decision now? That inquiry is indispensable in many clinical and legal settings, but it can obscure a second normative problem—who should exercise decision authority when ability is partial, support-sensitive, temporally unstable, or distributed across relationships. This article develops an original relational framework for analysing that problem without displacing functional capacity assessment or c
Written by David Osei
Published in Vol 6 Issue 1, 2026
Clinical efficiency is indispensable to safe, timely, and sustainable care, yet it may also function as an unacknowledged moral teacher when organizational tempo repeatedly determines what receives time, protection, and attention. This critical conceptual article examines how time pressure may become part of medicine’s hidden ethics curriculum. Drawing on evidence from medical education, clinical communication, professional identity formation, patient-centred care, and learning-environment resea
Written by Kristian Eriksen
Published in Vol 6 Issue 1, 2026
Assessment in healthcare ethics education carries an unusual validity problem: learners may reach different conclusions while reasoning carefully, yet conventional scoring can make agreement with an expected answer easier to reward than the quality of the reasoning that produced it. This scholarly perspective examines that problem as a question of construct definition and assessment fairness rather than as evidence that disagreement is inherently virtuous or that expert consensus is inherently u
Written by Mikko Lahtinen
Published in Vol 6 Issue 1, 2026
Artificial intelligence is becoming embedded in diagnosis, documentation, communication, risk prediction, and clinical decision support. These uses complicate autonomy because patients may depend not only on a clinician's recommendation but also on models they cannot inspect, organizations that select and monitor those models, data infrastructures that may change, and clinicians whose own knowledge and communication are increasingly mediated by AI. Conventional informed consent remains indis
Written by Omar Zayed
Published in Vol 6 Issue 1, 2026
Ethical competence is widely invoked in health-professions education, yet the term encompasses heterogeneous claims about knowledge, moral reasoning, sensitivity, judgement, character, communication, action and professional conduct. Instruments intended to assess these capacities frequently operationalise narrower constructs, creating uncertainty about what particular scores establish and whether measured performance represents ethically desirable professional practice. This critical review used
Written by Wei Zhang
Published in Vol 6 Issue 1, 2026
Clinical decision support increasingly places clinicians in a distinctive moral position: they remain answerable for decisions while acting in an informational environment partly structured by algorithmic recommendations. The ethical problem therefore begins not only when an algorithm makes a decision, but after advice has been received and a clinician must follow, modify, delay, seek review of, override, or ignore it. This normative-responsibility analysis examines how those responses alter the
Written by Rafael Mendoza
Published in Vol 6 Issue 1, 2026
High-stakes clinical decisions are increasingly shaped by algorithmic systems that may inform diagnosis, treatment, triage, discharge, risk classification, and access to scarce interventions. Ethical discussion has often emphasized notice, disclosure, transparency, and explanation. These protections are important but incomplete when an affected patient cannot ask why a consequential decision was made, obtain reconsideration by an empowered clinician, or secure revision when the decision cannot b
Written by Wouter De Smet
Published in Vol 6 Issue 1, 2026
High-stakes clinical decisions are usually evaluated through familiar ethical categories: informed consent, capacity, shared decision making, proportionality, best interests, and respect for autonomy. Less attention is given to whether the decision pathway itself preserves a meaningful opportunity to reconsider before options, bodily states, information, or time are irretrievably lost. This article develops a normative decision-design account of clinical reversibility. It distinguishes the techn
Written by Ana Rodrigues
Published in Vol 6 Issue 1, 2026
Artificial intelligence is entering clinical decision-making faster than health-professions education has established shared expectations for the ethical capabilities clinicians need when using, questioning, explaining, or overriding AI-supported recommendations. Existing literature spans technical literacy, professionalism, ethics teaching, learner attitudes, competency frameworks, assessment, and implementation, but these domains should not be treated as equivalent evidence of clinical compete
