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Objectives: In the province of Quebec, Canada, interdisciplinary support groups (ISGs) are mandated to support those who are involved in the clinical, administrative, legal and ethical aspects of medical assistance in dying (MAiD). This article presents the results of a mixed-method, multi-phase study carried out in 2021 on ISGs with the aim to describe current ISG practices, critically analyze them and make recommendations on promising practices for provincial implementation. Method: Semi-structured interviews (42) and focus groups (7) with coordinators of 24 ISGs were used to identify promising practices and confirm their utility with participants. Results: We have distributed the ISGs along what we coined an "ISG continuum." Between teams' accountability (decentralization) and ISGs' assumption of responsibility for MAiD requests (centralization), a middle ground approach, focused on the value of support, should be favored. Conclusion: The structuring of ISGs and their practices is intimately linked to their values. Harmonization of ISGs and their practices, while considering their specific values and contexts, can contribute to the equity and quality of services intended for those who request MAiD and those who support them.

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BACKGROUND: Social accountability aims to promote a collective ethic that upholds the fundamental values of equity, efficiency, solidarity, and social justice in healthcare and is now considered as a critical mission of academic health centers. Collaborative Online International Learning (COIL) is a pedagogical approach that uses digital technology to provide experiential international learning, specifically for increasingly diverse and multicultural healthcare work environments. The SOLID'AIRS program is an innovative French-language COIL that aims to set up international exchanges and workshops on social accountability between health sciences students. The aim of our study was to assess the impact of participation in the SOLID'AIRS program on medical and pharmacy students. METHOD: Five universities in four different countries were involved in SOLID'AIRS. We conducted a qualitative study by performing individual, semi-directed interviews with students who participated in the program from 2021 to 2022. A thematic analysis was conducted in five chronological phases: (1) reading, (2) descriptive coding, (3) conceptual coding, (4) identification of themes and (5) production of a coherent thematic structure. RESULTS: After including sixteen student participants, 13 medical and 3 pharmacy students, we identified four main themes related to the impact of participation: (1) previous experiences in social accountability and international learning, (2) perception of the program, (3) perceived impacts of the program, and (4) difficulties encountered and avenues to improve the program. Overall, the program was well received by all participants who reported the advantages and limitations of the online learning format. The primary advantage of this format was its feasibility. The participants noted both professional and personal benefits of the program for their current and future practice, including greater reflexivity towards health sciences practice. Based on the challenges faced during the program, particularly in coordinating group work and communication, participants suggested increased supervision of group projects by collaborators, and organizing at least one in-person meeting for future editions. The participants reported encountering difficulties during the COIL and suggested ways of improvement. CONCLUSION: Participating in a COIL on social accountability appears to be an effective way to adopt a reflective approach to medical practice and should be implemented and evaluated in other educational contexts.

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This research explores the perspectives of academic physicists from three national contexts concerning their roles and responsibilities within the realm of science. Using a dataset comprised of 211 interviews with scientists working in China, the United States, and the United Kingdom, the study seeks to explain whether and in what manner physicists conceptualize scientific ethics within a global or national framework. The empirical findings bring to light disparities across nations in the physicists' perceptions of what constitutes responsible mentorship and engagement in public service. These cross-national variations underscore the moral agency of physicists as they navigate the ethical standards embraced by the global scientific community vis-à-vis those that are specific to their respective national contexts. The study's empirical insights may carry significant implications for both policymakers and ethicists, underscoring the imperative of soliciting and acknowledging the perspectives of academic scientists working and living in disparate national contexts when formulating comprehensive science ethics frameworks. Such inclusive and context-aware approaches to shaping ethics in science can contribute to the cultivation of a more robust and universally relevant ethical foundation for the scientific community.

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BACKGROUND: Workers tasked with specific responsibilities around patient and public involvement (PPI) are now routinely part of the organizational landscape for applied health research in the United Kingdom. Even as the National Institute for Health and Care Research (NIHR) has had a pioneering role in developing a robust PPI infrastructure for publicly funded health research in the United Kingdom, considerable barriers remain to embedding substantive and sustainable public input in the design and delivery of research. Notably, researchers and clinicians report a tension between funders' orientation towards deliverables and the resources and labour required to embed public involvement in research. These and other tensions require further investigation. METHODS: This was a qualitative study with participatory elements. Using purposive and snowball sampling and attending to regional and institutional diversity, we conducted 21 semi-structured interviews with individuals holding NIHR-funded formal PPI roles across England. Interviews were analysed through reflexive thematic analysis with coding and framing presented and adjusted through two workshops with study participants. RESULTS: We generated five overarching themes which signal a growing tension between expectations put on staff in PPI roles and the structural limitations of these roles: (i) the instability of support; (ii) the production of invisible labour; (iii) PPI work as more than a job; (iv) accountability without control; and (v) delivering change without changing. CONCLUSIONS: The NIHR PPI workforce has enabled considerable progress in embedding patient and public input in research activities. However, the role has led not to a resolution of the tension between performance management priorities and the labour of PPI, but rather to its displacement and - potentially - its intensification. We suggest that the expectation to "deliver" PPI hinges on a paradoxical demand to deliver a transformational intervention that is fundamentally divorced from any labour of transformation. We conclude that ongoing efforts to transform health research ecologies so as to better respond to the needs of patients will need to grapple with the force and consequences of this paradoxical demand.

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PAHO Forward is a results-based, Organization-wide initiative to systematically innovate and modernize management practices to increase efficiency, transparency, and accountability internally and externally. The PAHO Forward Plan of Action 2.0 operationalizes the PAHO Forward framework and includes the specific objectives of strengthening the Pan American Sanitary Bureau (PASB) efficiency, transparency, and accountability; bolster the Pan American Health Organization (PAHO) visibility, country focus, and capacity to deliver technical cooperation; enhance the PASB human resources performance and drive innovation to move the Organization forward. This report describes the main components of the updated plan, and outlines the full list of actions and expected results that have been prioritized by PAHO Forward Governance for the period June 2024 to May 2025.

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This Viewpoint summarizes methods used by health care organizations to assess and improve clinician well-being, discusses the potential downsides of public reporting of clinician well-being survey data, and calls for making organizations' adherence to structure and process measures a part of accreditation criteria.

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In a series of papers in the early 1970s and in his important book Abortion and the Sanctity of Human Life (1975), Baruch Brody offered what remains to this day one of the most philosophically rigorous contributions to the debate concerning the morality of abortion and the ethics of homicide more generally. In this paper I would like to critically examine Brody's argument that abortion is sometimes justifiable in some cases even when (1) one cannot claim self-defense, or (2) diminished responsibility, and (3) the abortion is a 'killing' rather than a 'not saving.' This justification, I argue, is limited to certain cases in which the life of the mother is at stake. The cautious principle which he finally formulates merits serious attention and consideration. While I find a great deal of value in Brody's discussion, I will argue that there are several difficulties with the principle of justifiable homicide he constructs. Accordingly, I will further amend and supplement his final version by offering my own alternative principle.

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The Journal of the Medical Library Association (JMLA) has made the decision to change our "revise-at-will" policy to instead adopt firmer deadlines for manuscript resubmissions. Beginning with this issue, manuscripts returned to authors with a "revise and resubmit" decision must be resubmitted within two months of the editorial decision. Likewise, manuscripts returned to authors with a "revisions required" decision must be resubmitted within one month of the editorial decision. This editorial discusses JMLA's experience using a "revise-at-will" policy and outlines some anticipated benefits of the new resubmission deadlines.

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The establishment of green finance reform and innovation pilot zone (GFRIPZ) is a pivotal strategy for harmonizing the twin goals of economic prosperity and environmental preservation. By applying panel data on Chinese A-share listed firms from 2011 to 2022, this study examines the influence of China's green finance pilot policy on corporate environmental social responsibility (ESR) using a difference-in-differences (DID) model. The study's findings indicate that the green finance pilot policy promotes corporate environmental social responsibility. The results remain robust after a series of robustness tests. Moreover, mechanism analysis reveals that the pilot policy promotes firms' ESR through three key channels: financing constraints, green innovation, and corporate governance mechanisms. Additionally, analyst attention can positively moderate the promotional effect of the green finance pilot policy on corporate ESR. Furthermore, this study reveals that the green finance pilot policy's impact on corporate ESR is more pronounced among large-scale firms and firms operating in regions characterized by stringent environmental regulations and greater marketization. The empirical findings present evidence for enhancing ESR through the implementation of the green finance pilot policy in China and offer insights for refining the green finance system.

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This study aims to examine the impacts of internal and external corporate social responsibility (CSR) on managers' pro-environmental behaviors with the mediating role of green reputation and moderating of chief sustainability officer (CSO). We acquired information from 609 managers working in various Chinese manufacturing firms using a standardized survey tool. Structural equation modelling (SEM) was performed to analyze data. Our major findings are as follows. First, both internal and external CSR influence the pro-environmental behaviors of managers through the mediation role of corporate green reputation. Second, the CSO significantly moderates the relationship between CSR actions and corporate green reputation. Our study contributes to the body of current knowledge by giving empirical evidence for the theoretical framework linking CSR, reputation, and pro-environmental behavior. The findings from this study offer managerial insights for businesses that deliberately want to promote environmentally friendly activities.

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This study delves into the interconnections among corporate social responsibility, green intellectual capital, green ambidextrous innovation, and sustainable performance, particularly in the context of Industry 4.0 and sustainability. A questionnaire-based survey was conducted, and a sample of 317 small and medium enterprises was collected. Using Partial Least Squares Structural Equation Modeling in Smart-PLS v4, the findings reveal a significant relationship between corporate social responsibility and sustainable performance, with green intellectual capital and green ambidextrous innovation serving as mediating factors. Moreover, the study highlights the moderating role of Industry 4.0 among green intellectual capital and green ambidextrous innovation with sustainable performance. These findings may guide the managers in designing and implementing CSR strategies beyond compliance and contributing to competitive advantage through green intellectual capital and green ambidextrous innovation for business success in the era of Industry 4.0.

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Teamwork and effective communication between all health care staff members are essential to providing safe, high-quality patient care. High-reliability organizations align behavioral expectations with organizational values and prioritize safety over other performance metrics and pressures. Communication breakdowns, such as inadequate or incomplete information shared between caregivers, continues to be an issue that is linked to errors and staff member dissatisfaction. Initiatives to improve health care communication and improve patient outcomes are well documented, yet communication issues in the health care setting continue. An organization's credo defines its values and behavioral expectations. Educating team members on an organization's credo creates accountability among those teams to align their behavior with the organization's values, policies, and professional commitment. A Coworker Observation Reporting System offers a communication method for providing meaningful feedback on behaviors inconsistent with an organization's credo.

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Effective communication is crucial in health care and contributes to safe patient care and organizational excellence. Hierarchical differences can negatively affect communication among clinicians; however, recognizing and addressing power imbalances can improve patient safety. Individuals can feel empowered to express concerns and provide constructive feedback through clear communication with active listening. Perioperative nurses and leaders can use a variety of strategies to enhance accountable (or critical) conversations, such as structured communication models that guide participants through conversations and standardized procedures and tools to enhance the quality of team communication. This article provides an overview of accountable conversations, discusses the importance of structured communication models, and offers scenario-based examples using two structured models to enhance the reader's understanding. Finally, the article describes cultural competence and the leader's role in developing a culture of accountability.

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This study aims to assess the associations among students' perceptions of climate change, university social responsibility (USR), and environmental sustainability practices at a medical university. It also aims to identify the factors associated with these elements. A cross-sectional self-report study was conducted with a total sample of 416 undergraduate students from a medical university in Taiwan during October 2019. Data gathered comprised sociodemographic characteristics, perceptions of climate change issues, environmental sustainability practices, measure for perception toward USR, and transportation modes. Chi-square test, Fisher's exact test, two-sample t test, and multiple linear regression models were used. Results of multiple linear regression demonstrated that the level of certainty in climate change existence (extremely and mostly certain vs somewhat or not certain at all, 1.45 [0.68]), score for usage of nonpublic transportation (per 1-point increase, 0.52 [0.25]), and students' perception toward USR (per 1-point increase, 0.14 [0.04]) were associated with the total score of environmental sustainability practice (R-square = 11.47%). In addition, school year (non-freshmen vs freshmen, -1.64 [0.65]) and environmental sustainability practices (per 1-point increase, 0.23 [0.06]) were associated with the total score of students' perception of USR (R-square = 6.57%). Promoting environmental sustainability among university students can be achieved by implementing USR-oriented courses or activities. Our research is pioneering in investigating and discussing the perceived USR and environmental sustainability practices among university students in Taiwan.

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Due to its enormous potential, artificial intelligence (AI) can transform healthcare on a seemingly infinite scale. However, as we continue to explore the immense potential of AI, it is vital to consider the ethical concerns associated with its development and deployment. One specific concern that has been flagged in the literature is the responsibility gap (RG) due to the introduction of AI in healthcare. When the use of an AI algorithm or system results in a negative outcome for a patient(s), to whom can or should responsibility for that outcome be assigned? Although the concept of the RG was introduced in Anglo-American and European philosophy, this paper aims to broaden the debate by providing an Ubuntu-inspired perspective on the RG. Ubuntu, deeply rooted in African philosophy, calls for collective responsibility, and offers a uniquely forward-looking approach to address the alleged RG caused by AI in healthcare. An Ubuntu-inspired perspective can serve as a valuable guide and tool when addressing the alleged RG. Incorporating Ubuntu into the AI ethics discourse can contribute to a more ethical and responsible integration of AI in healthcare.

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This commentary explores the critical roles of health equity and ethical considerations in the deployment of artificial intelligence (AI) in public health and medicine. As AI increasingly permeates these fields, it promises substantial benefits but also poses risks that could exacerbate existing disparities and ethical challenges. This commentary delves into the current integration of AI technologies, underscores the importance of ethical social responsibility, and discusses the implications for practice and policy. Recommendations are provided to ensure AI advancements are leveraged responsibly, promoting equitable health outcomes and adhering to rigorous ethical standards across all populations.

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The commentary "Public health ethics and the Kerala Public Health Act, 2023" published on January 27, 2024 in the Indian Journal of Medical Ethics (IJME) has received a response from members of the State Health Systems Resource Centre and Government Medical College, Malappuram, Kerala. They explain that the Kerala Public Health Act (KPHA) is a legal document and not required to explicitly include accountability mechanisms and social obligations of the state. Given the very real danger of state over-reach as was evident during the Covid pandemic, these checks and balances should, in fact, be non-negotiable. The position of KPHA on healthcare of migrant workers and patients with tuberculosis goes against existing public healthcare principles. There is therefore a need to revisit the Act to explicitly include state accountability.

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The results and details of the clinical studies and research must be securely stored to ensure reliability, accountability, and prevent malicious misuse. To accomplish this, a secure method for storing metadata and study results is crucial. Also, a mechanism to ensure accountability for both data owners and researchers is needed. In this way, data owners and the scientific community can rely on and verify results and methods presented by researchers, while researchers can check the validity of the analyzed data and have proof of authorship for their work. A modular framework is presented in this paper, which utilizes blockchain and cryptography to store study results and metadata, along with proof of accountability. The framework has been tested within a privacy-preserving distributed analytics infrastructure.

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