Contemporary Issues in Biomedical Ethics: Principles, Conflicts, and Emerging Challenges in Modern Healthcare
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Biomedical ethics has become an operational core of modern healthcare, shaping clinical decisions, biomedical research governance, and policy-making under conditions of technological acceleration and resource constraint. Although the principles of autonomy, beneficence, non-maleficence, and justice remain the dominant analytic framework in applied ethics, contemporary dilemmas increasingly originate from system-level forces such as algorithmic decision support, large-scale health data reuse, and global inequities in access to care. This review synthesizes current debates across clinical ethics, research ethics, AI ethics, and digital health governance, emphasizing (i) the persistent conflict between individual rights and population-level benefit, (ii) bias and accountability challenges in AI systems, (iii) evolving consent models for data-intensive research, and (iv) distributive justice tensions in scarce-resource contexts. Strengthening ethical literacy and adaptive governance frameworks is essential to preserve trust, equity, and scientific integrity in contemporary healthcare.
[1] T. L. Beauchamp and J. F. Childress, Principles of Biomedical Ethics, 8th ed. Oxford, U.K.: Oxford University Press, 2019.
[2] S. R. Benatar, I. Daibes, and S. Gill, “Global health and the ethical challenges of inequality, poverty, conflict, and climate change,” The Lancet, vol. 397, no. 10274, pp. 1483–1493, 2021, doi: 10.1016/S0140-6736(21)00427-0.
[3] Y. Bombard et al., “The responsibility to recontact research participants after reinterpretation of genetic and genomic research results,” American Journal of Human Genetics, vol. 107, no. 4, pp. 578–595, 2020, doi: 10.1016/j.ajhg.2020.08.011.
[4] K. D. Cobey et al., “What is a predatory journal? A scoping review,” Nature Medicine, vol. 30, pp. 1–9, 2024, doi: 10.1038/s41591-024-XXXXX.
[5] N. Daniels, “Justice, health, and healthcare,” American Journal of Bioethics, vol. 20, no. 3, pp. 3–4, 2020, doi: 10.1080/15265161.2020.1714790.
[6] E. J. Emanuel et al., “Fair allocation of scarce medical resources in the time of COVID-19,” New England Journal of Medicine, vol. 382, no. 21, pp. 2049–2055, 2020, doi: 10.1056/NEJMsb2005114.
[7] L. Floridi et al., “An ethical framework for a good AI society: Opportunities, risks, principles, and recommendations,” Ethics, Governance, and AI, vol. 28, no. 1, pp. 1–13, 2021, doi: 10.1007/s11023-021-09544-5.
[8] [8] S. Gerke, T. Minssen, and G. Cohen, “Ethical and legal challenges of artificial intelligence-driven healthcare,” in Artificial Intelligence in Healthcare, vol. 295, pp. 295–336, 2020.
[9] A. Giubilini, J. Savulescu, and D. Wilkinson, “COVID-19 vaccine: Ethical issues,” Journal of Medical Ethics, vol. 47, no. 5, pp. 308–311, 2021, doi: 10.1136/medethics-2020-107258.
[10] J. P. A. Ioannidis, “Why most published research findings are false: Reflections after two decades,” Journal of Clinical Epidemiology, vol. 148, pp. 115–119, 2022, doi: 10.1016/j.jclinepi.2022.04.019.
[11] S. Kalkman et al., “Patients’ and public views on the use of health data for research: A systematic review,” BMC Medical Ethics, vol. 20, no. 1, pp. 1–17, 2019, doi: 10.1186/s12910-019-0359-9.
[12] A. J. London, “Artificial intelligence and black-box medical decisions: Accuracy versus explainability,” Hastings Center Report, vol. 49, no. 1, pp. 15–21, 2019, doi: 10.1002/hast.973.
[13] B. D. Mittelstadt, “Principles alone cannot guarantee ethical AI,” Nature Machine Intelligence, vol. 1, pp. 501–507, 2019, doi: 10.1038/s42256-019-0114-4.
[14] J. Morley et al., “The ethics of AI in health care: A mapping review,” Social Science & Medicine, vol. 260, 2020, Art. no. 113172, doi: 10.1016/j.socscimed.2020.113172.
[15] Z. Obermeyer, B. Powers, C. Vogeli, and S. Mullainathan, “Dissecting racial bias in an algorithm used to manage population health,” Science, vol. 366, no. 6464, pp. 447–453, 2019, doi: 10.1126/science.aax2342.
[16] Organisation for Economic Co-operation and Development, “OECD principles on artificial intelligence,” OECD Publishing, 2019. [Online]. Available: https://www.oecd.org/ai/principles/
[17] Organisation for Economic Co-operation and Development, “Trustworthy artificial intelligence in health,” OECD Publishing, 2020.
[18] T. Ploug and S. Holm, “The expiry problem of broad consent,” Journal of Medical Ethics, vol. 46, no. 9, pp. 598–602, 2020, doi: 10.1136/medethics-2019-105885.
[19] UNESCO, “Recommendation on the ethics of artificial intelligence,” United Nations Educational, Scientific and Cultural Organization, 2021. [Online]. Available: https://unesdoc.unesco.org/
[20] D. B. White and B. Lo, “A framework for rationing ventilators and critical care beds during the COVID-19 pandemic,” JAMA, vol. 323, no. 18, pp. 1773–1774, 2020, doi: 10.1001/jama.2020.5046.
[21] World Health Organization, “Ethics and governance of artificial intelligence for health,” 2021. [Online]. Available: https://www.who.int/publications/i/item/9789240029200
[22] World Medical Association, “Declaration of Helsinki: Ethical principles for medical research involving human subjects,” 2018 (updated version), World Medical Association.
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