Against a backdrop of rapidly expanding health artificial intelligence (AI) development, this paper examines how the European Union’s (EU) stringent digital regulations may incentivise the outsourcing of personal health data collection to low- and middle-income countries (LMICs), fuelling a new form of AI ethics dumping. Drawing on parallels with the historical offshoring of clinical trials, we argue that current EU instruments, such as the General Data Protection Regulation (GDPR), Artificial Intelligence Act (AI Act) and Medical Devices Regulation, impose robust internal safeguards but do not prevent the use of health data collected unethically beyond EU borders. This regulatory gap enables data colonialism, whereby commercial actors exploit weaker legal environments abroad without equitable benefit-sharing. Building on earlier EU responses to ethics dumping in clinical trials, we propose legal and policy pathways to prevent similar harms in the context of AI.

The growing prominence of patient and public involvement in health services has led to the increased use of experiential knowledge alongside medical and professional knowledge bases. Third sector organisations, which position themselves as representatives of collective patient groups, have established channels to communicate experiential knowledge to health services. However, organisations may interpret and communicate experiential knowledge in different ways, and due to a lack of inherent authority, it can be dismissed by health professionals. Thus, drawing on individual interviews with organisation representatives, we explore the definitions and uses of as well as the ‘filters’ placed upon experiential knowledge. The analysis suggests that whilst experiential knowledge is seen as all-encompassing, practical and transformative, the organisations need to engage in actions that can tame experiential knowledge and try to balance between ensuring that the critical and authentic elements of experiential knowledge were not lost whilst retaining a position as collaborators in health care development processes.

After Dobbs v. Jackson Women’s Health Organization, the United States Supreme Court decision that overturned Roe v. Wade in 2022, OB/GYN residents’ access to abortion training, which is required in all accredited programs, has come under pressure. To receive the foundational training doctors in the field need, many residents in ban states travel to out-of-state programs where abortion is legal. But demand is high, travel for multiple weeks is expensive, and the capacity to train at host sites is limited.

Training by travel could have ripple effects for the quality of patient care. As the number of OB/GYNs continues to decrease, newly-trained providers will have different, and arguably diminished, skills in delivering not just elective but also medically necessary abortion care. And as exceptions for life and health become how legal, procedural terminations take place in one-third of the United States, there is no guarantee that the doctors in those states will feel comfortable providing that care.

This article explores the residency training provided today, providers’ and institutions’ navigation of abortion bans, and what changes in residency programs might mean for patient care in the coming years. Part I surveys the landscape of abortion law after Dobbs; even the strictest bans contemplate instances when abortion is medically required and legally permitted. Part II summarizes the pre- and post-Dobbs expectations for abortion training for OB/GYN residents, describing how graduate medical education has changed for residents in ban states. Part III assesses shorter and longer-term effects of a system that relies on travel and simulation (the use of models) or is out of compliance with national accreditation standards. Part IV concludes with potential paths forward that depend on state and national organizations supporting and funding the networks of health care professionals that facilitate training across the country.

This paper addresses the comprehensive regulation of artificial intelligence (“AI”) across its entire lifecycle in the health care sector. It builds on a proposal for a True Lifecycle Approach (“TLA”) to address governance gaps across three phases of AI and expands the framework with detailed practical insights for governing health care AI, drawing on pioneering examples from Qatar, Saudi Arabia, and the United Arab Emirates (“UAE”) as models for global implementation. Beginning with the research and development phase, it highlights the urgent need for robust guidelines and certification processes to ensure that AI technologies are developed in compliance with ethical and safety standards. Moving into the approval stage, the discussion explores how AI systems can be effectively regulated under existing medical device frameworks, emphasizing the need for tailored regulations that consider the unique challenges posed by AI. Finally, the paper delves into the deployment of AI in clinical practice, examining the gaps in current laws and the need for a coherent and consistent regulatory framework that can adapt to AI advancements. The paper argues that the existing legal structures are inadequate, often inconsistent, and fail to address the complexities of AI in health care. It argues for a broader regulatory approach focused on patient safety throughout the AI lifecycle.

The article introduces the special issue by mapping the field of pertinent scholarship and situating the articles with regard to the special angles and contributions they have to offer. As our five articles present case studies from Bulgaria and the GDR, both state socialist countries and their health care systems are portrayed here to provide context. The introduction locates each of the contributions and the overarching aims of the special issue within current scholarly discussions and demonstrates the issue’s innovative potential.

Voluntary firearm safety actions avoid Second Amendment scrutiny, but rely on individuals recognizing their own risks. This could be aided by a network of healthcare professionals that have received proper training and information about all available tools to help prevent firearm-related suicide attempts, and combining the trust of clinicians and firearm owners could represent an opportunity to inform and educate in a manner that will engage patients.

What does it mean to be a public Catholic institution in Canada? How does this Catholic identity evolve with the secularisation and diversification of society, and with the rising awareness of the complicated legacy of Catholicism and colonisation in Canada? This article explores those questions drawing on document analysis and interviews with staff working in Catholic health care. Taking a legal pluralist approach, it documents how Catholic health-care institutions navigate between transnational canon laws and ethics, and human rights law. Catholic health care is situated in a web of national and transnational legal regimes. We argue that this navigation takes different forms to adapt to societal changes, such as the authorization of Medical Assistance in Dying (MAiD). This article speaks directly to how Christianity continues to play a subtle, but still constant presence in Canadian Catholic hospitals, and debunks tropes that construct relationships between state and religion as one of clear separation.

In the Dutch health care system of regulated competition, health insurers are assigned the crucial role of prudent purchasers and expected to critically contract providers based on the quality and prices of their services. Thus far, however, these organisations have struggled to fulfil this role. This study sheds new light on the purchasing behaviour of Dutch health insurers. We examine how insurers perceive the context in which the value-based purchasing of hospital care should take shape, and we draw on insights from institutional theory to frame our analysis. Our findings are based on a series of semi-structured interviews (n = 18) with employees and representatives of several insurer companies whose combined market shares add up to over 90 per cent of all premium payers. Our analysis highlights an environment in which market mechanisms are tangled up with historically rooted budgeting practices, where insurers are pressured to sustain rather than critique hospitals, and where self-regulating medical professionals are firmly supported by society’s deep-seated belief in the quality of their services. Like many other organisations, Dutch health insurers tend to conform to their institutional environment. While this conformity may aid them in organisational stability and survival, it also restricts their ability to purchase prudently.

With society’s growing diversity, it is increasingly crucial to comprehend the care needs of older migrants with dementia and their informal carers. This study explores the experiences of informal carers of older migrants with dementia using professional care, focusing on the participants’ perceptions of whether the delivered professional care meets the needs of the informal carer and their family member with dementia. Purposive sampling identified 17 informal carers living in Belgium and caring for older first-generation labour migrants from Italian and Turkish backgrounds. In-depth interviews were conducted and inductive data were analysed using the Qualitative Analysis Guide of Leuven, a method inspired by the constant comparative method. The findings are presented through composite narrative vignettes. The data analysis revealed six predominant themes: (1) Informal carers are hoping for engagement from professional care providers, to create together a care alliance for the older person with dementia; (2) Informal carers experience cold substandard care provision from professional care providers towards their loved ones; (3) Informal carers need to feel a sense of home to be able to trust the professional care providers; (4) Informal carers experience culturally insensitive care practices by professional care providers; (5) Informal carers struggle with the responsibility of informal care-giving in the context of today’s world; (6) Informal carers experience the cumulative mental load of care-giving. Informal carers of older migrants with dementia face a cumulative mental burden through limited adapted-care options, cultural insensitivity in services, care-giving duties and additional tasks to bridge the professional care gaps.