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Increasingly, researchers seek to engage communities, patients, and stakeholders as partners in the process and products of health research. However, there is no existing stakeholder-driven ethical framework for such engaged scholarship. We employed an iterative, stakeholder-engaged method to develop a data-driven framework for the ethical review and conduct of engaged scholarship. We used consensus development conference methods and a modified Delphi survey to engage 240 community members, ethicists, and academic researchers. This multi-staged process produced a framework with 4 domains: vision of equitable and just research, relationship dynamics, community-informed risk/benefits assessment, and accountability. Within the framework, 4 cross-cutting considerations and 15 statements explicate the stakeholders' priorities for the ethical review and conduct of engaged scholarship. Though the findings are promising, the study is limited in that it focuses on stakeholder perspectives, but does not actually evaluate or apply the findings in the field. The stakeholder-engaged framework provides a platform for further articulation of ethical practices and policy for engaged scholarship.

Around 7% of the world population lives in HICs, 33% in MICs and 60% in LICs.5 Yet, relative to their proportion in terms of the global population, authors from HICs account for an outsize share of the bioethics literature,6 7 as well as in general medical research, global health research and medical education.8–10 The same pattern is found in those who participate in the WCB, especially when the WCB is located in a HIC. Participation rates at the 2022 WCB in Basel were HICs: 42%, MICs: 12% and LICs: 4%, that is, HICs shares were 7 times higher while MICs accounted for less than half their population share, and LICs for less than 1/10th (at the 2020 WCB/Philadelphia, which was held online due to Covid-10 rates were HIC: 42%, MIC: 12%, LIC: 10%, 2018/Bangalore, HIC: 36%, MIC: 32% LIC: 32%—ECRs were often captured separately and account for the remainder, where applicable, all data via IAB).11 People from HICs have far more access, presence and influence. Challenges from sub-Saharan African value-laden judgements on mental health disorders’ by Ugar and Malele13; the research article ‘Ethical Issues in Nipah Virus Control and Research: Reversing Decades of Neglect in Bioethics’ Johnson et al. 14 and the student essay ‘Patient autonomy in an East Asian cultural milieu: a critique of the individualism-collectivism model’ by Max Ying Hao Lim are all particularly important in this regard, as they can contribute to addressing inequities in the body of bioethics scholarship and to correcting epistemic (in)justices.15 8 13 16–18 Ugar and Malele discuss the use of artificial intelligence and machine learning for the diagnosis and prognosis of diseases, especially mental health disorders, in a global context. [...]a generic or universal design cannot be effective’.

The education of medical students should be based on the best clinical information available, rather than on commercial interests. Previous research looking at university-wide conflict of interest (COI) policies used in Canadian medical schools has shown very poor regulation. An analysis of COI policies was undertaken to document the current policy environment in all 17 Canadian medical schools. A web search was used to initially locate COI policies supplemented by additional information from the deans of each medical school. Strength of policies was rated on a scale of 0 to 2 in 12 categories and also on the presence of enforcement measures. For each school, we report scores for all 12 categories, enforcement measures, and summative scores. COI policies received summative scores that ranged from 0 to 19, with 0 the lowest possible score obtainable and 24 the maximum. The highest mean scores per category were for disclosure and ghostwriting (0.9) and for gifts and scholarships (0.8). This study provides the first comprehensive evaluation of all 17 Canadian medical school-specific COI policies. Our results suggest that the COI policy environment at Canadian medical schools is generally permissive. Policy development is a dynamic process. We therefore encourage all Canadian medical schools to develop restrictive COI policies to ensure that their medical students are educated based on the best clinical evidence available, free of industry biases and COI relationships that may influence the future medical thinking and prescribing practices of medical students in Canada once they graduate.

OBJECTIVE: To describe and examine the role of the pharmaceutical industry in the teaching of psychopharmacology to residents and medical students and to make recommendations for changes in curriculum and policy based on these findings. METHODS: Literature reviews and discussions with experts, educators, and trainees. RESULTS: The pharmaceutical industry currently plays an extensive role in teaching psychopharmacology to trainees, both directly and indirectly. Attendance at industry-sponsored lectures and drug lunches, meetings with pharmaceutical representatives, and interactions involving the acceptance of various gifts are the most obvious venues. Less apparent but equally pervasive are the influence of industry-sponsored faculty and research and industry's effect on the climate of practice and the profession as a whole. Replacing medical education with industry promotion in the guise of scholarship causes demonstrable harm to trainees, the public, and the profession. CONCLUSIONS: In light of these findings, the medical profession must reassert control of medical education and draw a firm barrier between commercial and professional pursuits. These issues must be actively, explicitly, and rigorously discussed with our colleagues and students.

Objective: This article reviews and summarizes eight ethical guidelines of major professional organizations regarding the pharmaceutical industry's role in the psychiatric education of trainees. Method: The author conducted a literature review of research and guidelines pertaining to the pharmaceutical industry's relationship to trainees, with special attention to ethical implications. Results: A spectrum of ethical acceptability is represented in the various guidelines. The greatest disagreement exists regarding the appropriateness of gift-giving and hospitality. The greatest degree of consensus exists regarding the provision of and criteria for scholarships to trainees. Policies regarding the use of samples and the industry's influence on graduate medical education were less well developed compared with other areas. Conclusions: A review of guidelines can serve as a basis for dialogue, curricula development, and further research on the ethics of pharmaceutical company interactions with trainees in academic psychiatry.

Many bioethicists are involved in political advocacy groups as well as scholarship, and this has led to controversy. The virtues that enable scholarship to flourish are in tension with those that are vital for effective participation in political advocacy groups. This produces conflicts for bioethicists that are as serious as financial conflicts of interest. These conflicts cannot simply be eliminated, however. Scholars are citizens who have reason to engage in political action in light of their scholarly conclusions, and bioethicists who are political advocates are thoughtful persons who have reason to engage in scholarship. At best, the conflicts can be mitigated.

In line with the conference theme, we accept and support that clinical ethics ought to be engaged with communities. Yet, experience in patient and community engagement is not generally recognized as a valuable form of expertise that is prioritized in recruitment decisions for clinical ethics. Therefore, our goal is to discuss recruitment to the discipline, with particular emphasis on a future that promotes and reflects community engagement. Underrepresentation of diverse groups and the lack of community engagement in clinical ethics pose significant challenges. Clinical ethicists from minoritized communities can provide crucial insights to diversify perspectives in clinical ethics and healthcare, and to enhance commitments to health equity. Moreover, community-engaged ethicists play a vital role in strengthening the healthcare system's capacity to foster trust and safety with diverse communities and to recognize and respond to their needs. These opportunities are forfeit when members of minoritized communities are underrepresented within the discipline. We focus on recruitment to clinical ethics fellowships as they are often a gateway to the discipline; the question of \"whom to select as fellows\" is inherently intertwined with the vision of \"what bioethics should evolve into\"? The pedagogic decisions within fellowship programs hold political consequences. For example, choices made during intake and within the program influence the composition and future of the field. Due to the lack of intention and focus on diversification and community engagement, the recruitment and retention process often sustains the status quo, resulting in the selection of individuals who closely resemble those already established in the field. This selfreinforcing process, leads to future cohorts that are less likely to prioritize diversification and community engagement. Unfortunately, such choices have contributed to a lack of community engagement and inequitable representation within the discipline.

Background and Objectives: To address the difficulty of recruiting qualified ethicists, Fraser Health Ethics Services (B.C., Canada) is developing an ethics fellowship program to train and support the hireability of systems - level and clinically trained ethicists. This presentation details the development process of the fellowship and aims to contribute to the conversation on standardization and professionalization in the field of bioethics. Methods: Fraser Health pulled from different sources to assess current best practices and inform the structure and curriculum that their fellowship should adopt. The academic literature pertaining to postgraduate ethics programs and grey literature, namely websites of ethics programs and job postings for clinical ethicists in North America, were reviewed. Interviews of 7 fellowship directors, 10 mentors, and 7 past fellows from across Canada were conducted. Where available, program outlines were consulted. This fellowship also builds on Fraser Health's existing bioethics course and other capacity-building efforts within the organization. Results and Analysis: Preliminary thematic analysis of the environmental scan reveals variability in the fellowships' eligibility criteria, stipend, goals, length, syllabus, activities and opportunities, research component, site rotations, number of supervisors, areas of specialization in ethics, assessment practices, and measures of success. Notably, the applicability of the American Society for Bioethics and Humanities' Core Competencies and Certification (HEC-C) to the Canadian context is questioned. The program leads and preceptors stressed the importance of flexibility, such as adapting to the fellow's prior experience and skills, revising the fellowship's duration, and adjusting the fellow's tasks and projects based on their needs, progress, and interests, consultation requests received, and supervisors' availability. Barriers to the success of ethics fellowships include: funding, cost of living, logistics of rotations, events like a pandemic, inadequate supervision, and lack of support for the mentors in terms of time management, added responsibilities, and pedagogical approach. Conclusion: In light of these considerations and recommendations, Fraser Health's fellowship aims to be launched in the Fall of 2024. By thoroughly documenting its development process, Fraser Health Ethics Services hopes to respond to the desire for shared curricula and educational tools in the bioethics community and foster collaboration among ethics services across the country.