A JME editorial argues journals should require authors to declare any use of generative AI in manuscripts. The hard part, as ever, is defining what counts as substantive use.

A sharp review argues routine urine drug screening in palliative and cancer pain care shows no safety benefit and real harms: cost, stigma, and racial disparities.

A scoping review on how assisted dying laws reshape palliative care nursing: renegotiated values, shifting roles, and team conflict. Mostly Canadian data, but a nuanced, human picture.

A piece asks why contact sport gets a pass to inflict foreseeable head-injury harm the law won't tolerate elsewhere, and what would actually justify the exemption.

Lamb and Bertaud argue care-ethics approaches fit pediatric palliative care better than principlism, whose concepts were largely imported from adult medicine.

A strong new AJOB piece from my colleague Mark Navin on the ethics consultant's role when official vaccine guidance fractures. Required reading for clinicians facing this.

A digital health commentary names a real risk: "task shifting" onto patients as responsibility laundering, dressed up as empowerment.

A clarifying piece: "harm" is several concepts, and which one you reach for can change an ethics consult's outcome. We pressed a related point in our two AJOB OPC replies related to conscientious objection (one forthcoming).

Our paper defending secular hospitals' institutional conscience to refuse aggressive care for likely-permanently-unconscious patients is out, with open peer commentaries. Reply coming soon.

Ethics committees often pick the outcome they already feel is right, then hunt for a principle to justify it. Noticing that in yourself is most of the work.

A large US survey: adolescents who know they can consent on their own to STI/HIV testing are markedly more likely to get tested. Knowing the right may matter more than the law itself.

A systematic review finds almost no validated tools for assessing decision-making capacity in adolescents. Mark Navin and I flagged the same underlying ambiguity in our pediatric assent work.

Schools punish trainee "unprofessionalism" with no principled way to sort honest error from at-risk from reckless behavior. Just culture was built for exactly this.

Parker Crutchfield argues that letting individuals opt out of community-wide mosquito control can act as a veto on public health and shrink everyone's freedom.

I was honored to be invited and I'm excited to give this talk in August. I hope you can join us!

Physicians outside palliative care vary widely in what they intend with palliative sedation, leaning on proportionality rather than the doctrine of double effect.

More good work from Christian Vercler's group in Plastic and Reconstructive Surgery: when does routine imaging after craniosynostosis surgery serve the child, and when is it defensive habit? Which of our routines earn their place?

Mauch and colleagues in The Journal of Hand Surgery on the ethics of hand transplantation in immunocompetent kids: impermissible outside rigorous trials, given lifelong immunosuppression and scant pediatric data. Ethics ahead of practice.

A Journal of Medical Ethics piece on how health technology assessment should count the "personal utility" of a genomic test, splitting discretionary from justice-based personal utility. Useful where intuitions push past the strictly clinical.

Mark Navin and Douglas Diekema in JAMA Pediatrics, "Vaccine Policy and Eliminating Nonmedical Exemptions: Read the Room." Would you rather be right or be happy? Medicine often insists on being right even when it hurts kids.

The American Board of Pediatrics will soon require attesting that graduates are "practice ready." This Pediatrics piece defines it around help-seeking and collaboration, not lone independence.

Singh and Mello in JAMA on something inevitable: advertising inside AI clinical decision support. If the model recommending a drug is paid to surface it, decision support and marketing blur fast.

A Pediatrics study ran 3.7M LLM outputs on pediatric emergencies. Recommendations shifted with sociodemographic labels, flagging more testing and more suspicion of maltreatment for low-income and Black, unhoused cases. Bias in, bias out.

A Critical Care Medicine scoping review on families contesting brain death: how often it happens, what it looks like, and how thin the evidence is for how teams should respond. One of the unsettled corners of end-of-life care.

A Bioethics article on a priority-setting puzzle: rarity supposedly has no moral weight, yet we pay more for rare-disease treatments. The "bad numbers luck" argument says landing in a small population can be its own injustice.

A JAMA piece argues for primary care as a public utility, funded by a "common fund" pooling public and private dollars. With a third of US adults lacking primary care, the common-good framing is the interesting move.

A wonderful Annals of Internal Medicine history: during the 1955 Boston polio epidemic, residents and a student ran a ward and a research lab at once, no role boundaries, no formal consent. A provocative borderline case for teaching research ethics.

A discrete-choice study in The Journal of Pediatrics asks NICU parents what they value most. Top answers: team competence, communication, symptom management. Cultural and spiritual care ranked lowest.

A clean defense of conscientious objection in Theoretical Medicine and Bioethics, taking apart the "incompatibility thesis" that conscience-based refusal cannot coexist with professional duty.

The wellness office is what institutions offer instead of fixing the thing making everyone unwell. Burnout isn't mainly about hours. It's about alienation from the humanistic core of the work.

A striking JAMA Internal Medicine study: a blood-pressure incentive mostly produced re-measurement until the number looked "controlled," fewer med adjustments, and more strokes and heart attacks out to a year.

A qualitative AJOB Empirical Bioethics study on former HIV vaccine trial participants in Tanzania, and the psychological harms after a trial ends: uncertainty, dependence, unmet emotional needs researchers did not see.

A short JAMA piece names "slow life support" for imminently dying patients: gradually dialing back interventions instead of abruptly withdrawing them.

Pediatrics "Ethics Rounds": can a teen with legal authority over her own care refuse life-saving treatment? The panel argues that general capacity does not always include the capacity to refuse.

When are a study's risks actually "proportionate" to its social value? A technical account of risk evaluation that takes seriously the non-utilitarian motivations of participants, like altruism.

Every time a trainee error becomes a referral and a remediation plan, ask what the system did to set it up. We say we want a just culture, then reach for the individual, because the individual is the cheapest thing to (pretend to) fix.

A sharp history in Medical Humanities on Great Ormond Street's 1987-89 "Wishing Well" appeal, and how it leaned on sick children as the perfect fundraising figure. Berlant's "cruel optimism" and the privatization of care.

A defense of practical wisdom (phronesis) in Theoretical Medicine and Bioethics, against the view that it is a redundant concept: the integrative meta-virtue that directs the others in clinical judgment, and an accessible read for the classroom.

I was honored to be invited and I'm excited to give this talk in August. I hope you can join us!

A Theoretical Medicine and Bioethics piece reconstructs Cicely Saunders' idea of "total care": suffering as physical, psychological, social, and spiritual at once. A philosophical archeology of a foundational hospice concept.

Slow codes get treated as straightforward deception, which skips the more interesting question: why a clinician would ever feel driven to one. Where law bars a DNR even when CPR is plainly inappropriate, a slow code looks less like a lie than ethical disobedience. buff.ly/hR5WVGD

Max Kramer's new piece in Theoretical Medicine and Bioethics on the clinical ethicist as advisor: how to offer real recommendations without becoming the "ethics police." A clarifying contribution to what we are doing when we consult.

The International Conference on Clinical Ethics and Consultation just convened for the twentieth time, in Cleveland. Two decades of building clinical ethics consultation into a global discipline is worth marking. Congrats to the organizers on a great conference.

A Journal of Medical Ethics article arguing that the law's tolerance of foreseeable harm in contact sports rests on an unexamined "public interest" assumption that mounting evidence on head injury should force us to revisit.

A systematic review and meta-analysis in Medical Education on constructed-response situational judgement tests, now used by over a million health-professions applicants. Validity hinges on alignment with what you want to measure.

A Journal of Medical Ethics essay on Iranian physicians who quietly resisted state mandates after the 2022 protests, falsifying records and concealing identities so that care became resistance. Proposes a sliding scale of obligation under duress.

With the first pig-kidney xenotransplant trials underway, this Journal of Medical Ethics study asked the UK public what they make of it, raising questions about animals, risk, and where we draw the human and non-human line.

"Ethical Disobedience: Harm, Futility, and the Slow Code" featuring @jasonadamwasserman.bsky.social. 🗓 Tuesday, August 18 ⏱ 12–1 p.m. (CDT) This free webinar offers the opportunity to earn IPE credits and certificates of attendance for CEUs. Learn more and register at: z.umn.edu/L18

A Theoretical Medicine and Bioethics article proposing a shared "grammar" for the long split between the biomedical account of disease and the lived experience of illness, treating both as parallel and comparable.

A Journal of Medical Humanities piece arguing that medicine's well-being frameworks stay stuck in transactional logics that feed burnout, and that flourishing is inseparable from how we form professional identity.