Nate W. Olson

Rural communities experience well-documented systemic disparities in health access and outcomes in comparison to urban populations. However, the ethical dimensions of these disparities have received only limited attention, and ethical issues related to rural health research have received even less. With the COVID-19 pandemic casting new light on these inequities, we conducted a scoping review to determine how much has been written on ethical issues in rural health research and which ethical issues are most prevalent. Four overarching ethical themes emerged through the search: resource inequity, underrepresentation, the benefits of community-based research, and challenges related to participant autonomy. Additionally, the search revealed a dearth of articles on ethical issues in rural health research, particularly in the United States. Thus, we propose four recommendations to revitalize and guide ethics discussions of research in rural communities, including growing the literature on ethical issues in rural U.S. communities, encouraging collaboration between rural health and bioethics researchers, improving recognition of rural heterogeneity, and addressing new issues in light of COVID-19. Acting on these recommendations would expand and support rural research efforts and ultimately help ameliorate rural–urban health inequities.

The rapid advances in genomics over the last decade have come to fruition amid intense public discussions of justice in medicine and health care. While much emphasis has been placed on increasing diversity in genomics research participation, an overly narrow focus on recruitment eschews recognition of the disparities in health care that will ultimately shape access to the benefits of genomic medicine. In this essay, we suggest that achieving a just genomics, both now and in the future, requires an explicit ELSI of translation—normative and pragmatic scholarship that embraces the interconnectedness of research and clinical care and centers the obligations of researchers, institutions, and funders to mitigate inequities throughout the translational pipeline. We propose core principles to guide an ELSI of translation and to ensure that this work balances the value of the generalizable knowledge that genomics research generates and the value of the individuals and communities who make this research possible.

In this article, I provide a new account of the basis of medical researchers' ancillary care obligations. Ancillary care in medical research, or medical care that research participants need but that is not required for the validity or safety of a study or to redress research injuries, is a topic that has drawn increasing attention in research ethics over the last ten years. My view, the relationship‐based approach, improves on the main existing theory, Richardson and Belsky's ‘partial‐entrustment model’, by avoiding its problematic restriction on the scope of health needs for which researchers could be obligated to provide ancillary care. Instead, it grounds ancillary care obligations in a wide range of morally relevant features of the researcher‐participant relationship, including the level of engagement between researchers and participants, and weighs these factors against each other. I argue that the level of engagement, that is, the duration and intensity of interactions, between researchers and participants matters for ancillary care because of its connection to the meaningfulness of a relationship, and I suggest that other morally relevant features can be grounded in researchers' role obligations.

During the COVID-19 pandemic, ethics centers were forced to reimagine program delivery. In a tumultuous time with rampant social isolation, the need for ethics education and dialogue was also critical. The authors, members of the directorship team of the Kegley Institute of Ethics, discuss how KIE met these challenges through organizing over fifty online events during the pandemic, including webinars, pedagogy workshops, ethics bowls, intercollegiate student conversations, colloquia, film viewings, and podcasts. The article describes both the opportunities and challenges that different types of virtual events present and argues that innovation in online programming can help ethics centers show ethical leadership in their communities. As one example, we discuss how online events can both enhance and hinder accessibility for participants. We also describe how online programming presents both barriers and opportunities for community building and can prompt ethics centers to reflect on their identities and missions.

ABSTRACT After initially pitting partisans against purists, the literature on the ethics of fandom has coalesced around a pluralist position: purists and partisans each have their own merits, and there is no ideal form of fandom. In this literature, however, the fair-weather fan continues to be viewed with dismissal and derision. While some fair-weather fans may earn this contempt, many fair-weather fans, we argue, are not only acceptable, they have important advantages over partisans and purists, and as such are in a better position to navigate some of the moral complexities inherent in modern sports. We develop this argument first by clarifying the nature of the fair-weather fan. We then examine challenges that fans face in many modern sports, first owing to their economic nature and, second, due to the morally tainted status of many of them. We argue that the fair-weather fan meets these challenges in ways that the partisan and purist cannot replicate.

In recent years, hospitals, clinics, and professional organizations have with increasing frequency pledged their commitment to “patient-and family-centered care”. The movement toward PFCC is especially pronounced in pediatrics, where the American Academy of Pediatrics has a long-held, explicit commitment to PFCC. However, the unified movement toward PFCC obscures differing conceptions of its purpose. First, patient-centered care, as opposed to provider- or disease-centered care, focuses on increasing patient involvement in care to accomplish two related, but distinct objectives: improving health outcomes and better respecting patients’ wishes. The Institute of...