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  1. Moral Stress and Moral Distress: Confronting Challenges in Healthcare Systems under Pressure.Mara Buchbinder, Alyssa Browne, Nancy Berlinger, Tania Jenkins & Liza Buchbinder - 2023 - American Journal of Bioethics 24 (12):8-22.
    Stresses on healthcare systems and moral distress among clinicians are urgent, intertwined bioethical problems in contemporary healthcare. Yet conceptualizations of moral distress in bioethical inquiry often overlook a range of routine threats to professional integrity in healthcare work. Using examples from our research on frontline physicians working during the COVID-19 pandemic, this article clarifies conceptual distinctions between moral distress, moral injury, and moral stress and illustrates how these concepts operate together in healthcare work. Drawing from the philosophy of healthcare, we (...)
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  • What makes a health system good? From cost-effectiveness analysis to ethical improvement in health systems.James Wilson - 2023 - Medicine, Health Care and Philosophy 26 (3):351-365.
    Fair allocation of scarce healthcare resources has been much studied within philosophy and bioethics, but analysis has focused on a narrow range of cases. The Covid-19 pandemic provided significant new challenges, making powerfully visible the extent to which health systems can be fragile, and how scarcities within crucial elements of interlinked care pathways can lead to cascading failures. Health system resilience, while previously a key topic in global health, can now be seen to be a vital concern in high-income countries (...)
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  • Bioethical Implications of Vulnerability and Politics for Healthcare in Ethiopia and The Ways Forward.Kirubel Manyazewal Mussie, Bernice Simone Elger, Mirgissa Kaba, Félix Pageau & Isabelle Wienand - 2022 - Journal of Bioethical Inquiry 19 (4):667-681.
    Vulnerability and politics are among the relevant and key topics of discussion in the Ethiopian healthcare context. Attempts by the formal bioethics structure in Ethiopia to deliberate on ethical issues relating to vulnerability and politics in healthcare have been limited, even though the informal analysis of bioethical issues has been present in traditional Ethiopian communities. This is reflected in religion, social values, and local moral underpinnings. Thus, the aim of this paper is to discuss the bioethical implications of vulnerability and (...)
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  • Pushing poverty off limits: quality improvement and the architecture of healthcare values.Guddi Singh, Vikki Entwistle, Alan Cribb & Polly Mitchell - 2021 - BMC Medical Ethics 22 (1):1-13.
    Background: Poverty and social deprivation have adverse effects on health outcomes and place a significant burden on healthcare systems. There are some actions that can be taken to tackle them from within healthcare institutions, but clinicians who seek to make frontline services more responsive to the social determinants of health and the social context of people’s lives can face a range of ethical challenges. We summarise and consider a case in which clinicians introduced a poverty screening initiative into paediatric practice (...)
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  • Ethical Challenges in Oral Healthcare Services Provided by Non-Governmental Organizations for Refugees in Germany.R. Kozman, K. M. Mussie, B. Elger, I. Wienand & F. Jotterand - forthcoming - Journal of Bioethical Inquiry:1-10.
    Oral healthcare is attracting much attention after decades of neglect from policymakers. Recent studies have shown a strong association between oral and overall health, which can lead to serious health problems. Availability of oral healthcare services is an essential part of ensuring universal healthcare coverage. More importantly, current gaps in its accessibility by minority or marginalized population groups are crucial public health as well as ethical concerns. One notable effort to address this issue comes from Non-Governmental Organizations (NGOs), which offer (...)
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  • Morisprudence: a theoretical framework for studying the relationship linking moral case deliberation, organisational learning and quality improvement.Niek Kok, Marieke Zegers, Hans van der Hoeven, Cornelia Hoedemaekers & Jelle van Gurp - 2022 - Journal of Medical Ethics 48 (11):868-876.
    There is a claim that clinical ethics support services (CESS) improve healthcare quality within healthcare organisations. However, there is lack of strong evidence supporting this claim. Rather, the current focus is on the quality of CESS themselves or on individual learning outcomes. In response, this article proposes a theoretical framework leading to empirical hypotheses that describe the relationship between a specific type of CESS, moral case deliberation and the quality of care at the organisational level. We combine insights from the (...)
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