Ethical Lens Research Articles

The Fertility Fix: the Boom in Facial-matching Algorithms for Donor Selection in Assisted Reproduction in Spain

This article reads the uptake of facial-matching algorithms by fertility clinics in Spain through the lens of ‘the fertility fix’: a software fix to the social reconfiguration of kinship and a fixed capital investment made by competing fertility companies and firms. ‘The fertility fix’ is proposed as a critical, ethical lens through which to situate algorithmic facial-matching in assisted reproduction in the context of the racial politics of the face and phenotype and the spatial politics of market expansion. While an ‘infertility crisis’ is often mentioned when explaining the growth of the assisted reproductive technologies (ARTs) industry, the use of donated reproductive cells is tied up in societal, ecological and economic shifts. Combining Software Studies analysis with Marxist Feminist and trans*feminist perspectives on shifting re/production dynamics, the article details the role of computational technologies in promoting certain ideas and beliefs about family and fixing certain territories of capital flow.

Learning From Community-Based Efforts Toward Shared Responsibility for Climate and Environmental Justice

In this exploratory inquiry, the research team investigates community-based data practices in climate and environmental justice initiatives. We set out to learn from the long history and current activities of communities seeking to hold corporate and government actors responsible to enact care for the climate and environment (e.g., monitoring air quality and waterways affected by petrochemical industries). Through a critical intersectional care ethics lens, we follow how groups respond to harms to ecosystems and seek healing, positioning their epistemic authority as they work with data (e.g., Ottinger, 2023; Puig de la Bellacasa, 2017). This work draws insights from inquiries which have examined how communities engage with climate action and efforts toward environmental sustainability (e.g., dos Santos et al., 2024; Kaczmarek, 2023; Nathan, 2012). Through a poster reporting on preliminary research, we share early analyses highlighting communities’ labor of resisting corporate delay, denial, and other dis- and mal-information practices, which slow or block urgently needed action and truth-telling. Methods involve analysis of archival records created by and about communities affected by the Love Canal toxic waste crisis in Western New York. The project aims to appreciate differences and similarities in community-based data practices, identifying further possibilities for information professionals and libraries, archives, and museums to uphold these data practices and associated knowledge and memory work, research, and storytelling. In turn, the team proposes future work to trace the development of community-based practices with climate and environmental data over time.

Environmentally sustainable person-centred care: Occupational therapy students' attitudes, perceptions and self-perceived preparedness for practice.

Climate change threatens the environments in which person-centred occupational therapy occurs. Environmental sustainability is directly linked with the health and wellbeing of current and future generations, presenting occupational therapists with a unique advocacy and activist role. As practitioners of the future, there is an urgent need to understand students' attitudes, perceptions of, and self-perceived preparedness for, dealing with environmental determinants of health and intergenerational occupational and climate justice. A cross-sectional exploratory descriptive survey collected United Kingdom (UK) based allied health professional students' attitudes, perceptions, and self-perceived preparedness for advocating for environmental sustainability in the context of person-centred care. The survey was distributed to 48 gatekeepers in UK institutions with approved allied health professional training programmes (44 offered occupational therapy); 62 occupational therapy students responded. Descriptive and non-parametric inferential statistics were used to analyse quantitative data. Text and short answers were analysed qualitatively via inductive content analysis. The study was co-designed and implemented with MSc (pre-registration) occupational therapy students. Participants (94%) expressed concerns for climate change, with 84% feeling responsible for addressing environmental sustainability in health care. While 64.5% identified climate justice as a top priority, a perceived challenge emerged between person-centred care and sustainability, with only 18% of participants feeling prepared for environmental sustainability in occupational therapy practice. Participants requested education on personal and professional sustainability practices, as well as collective action. Sharing personal climate change experiences, advocating with family and friends, and facilitating connections for collective action were highlighted as potentially transformative educational tools in this area. Occupational therapy curricula should address environmental sustainability through pragmatic, critical, and ethical lenses to enhance students' preparedness for this advocacy and activist role. Reflection and continuous professional development for environmentally sustainable practices is recommended. Occupational therapists believe that it is important to support people to participate in occupations that matter to them. However, the activities that some people choose to participate in may have negative effects on the environment and the planet. It is important to ensure that when occupational therapists support people in their choices of activities, this does not lead to unequal access to healthy and meaningful occupations of others, now or in the future. That is because occupational therapists also have a responsibility to prevent occupational injustice. Occupational therapy students are the professionals of the future, so it is important to include them in research about this topic. They need to develop skills that allow them to simultaneously make sure that they are delivering person-centred care, which is not environmentally detrimental and that does not lead to occupational injustice. Making sure that occupational therapists provide person-centred care while also managing risks of occupational injustice may be seen as a profession-specific dilemma. In this study, occupational therapy students in the UK completed a survey about their feelings, views, and readiness for managing this dilemma. Results showed that most respondents are concerned about climate change, but do not feel that their occupational therapy education sufficiently prepared them to practise in an environmentally sustainable way. They were asked to propose ideas for addressing this issue, and the article discusses how occupational therapy curricula might be changed in accordance.

Leadership and the ethics of hope: Václav Havel and the Charter 77 human rights movement in Czechoslovakia

Hope as a feature in both authentic and spiritual leadership theory has become a diminished moral concept, departing from its philosophical and theological roots, and distorted by excessive positivity, success, instrumentalization, cultural bias, and ideology. Following Ciulla’s (2014) assertion that biography can do much to inform leadership theory, this paper contributes a richer understanding of hope through the though case of Václav Havel and the Charter 77 human rights movement in Czechoslovakia using French existentialist Gabriel Marcel’s ethics of hope. Five elements of Marcel’s philosophy demonstrate hope’s transforming vulnerability amidst technological control, relationship with despair, active presence, creative fidelity, and transcending power in love. Examining Czechoslovakia’s human rights movement through the lens of Marcellian ethics provides insight into the role of absurdity and truth-telling as a precursor to hope, taking responsibility for failure, overcoming fear through the “solidarity of the shaken,” creative fidelity through living in truth and using humor, and love manifesting as sacrifice and openness to seeing one’s contribution to the moral contamination of society under totalitarianism.

Preparing the Workforce for Ethical, Responsible and Trustworthy AI

This article proposes a holistic multi-pronged strategy for establishing an ethical workforce ready for the rise of AI, beginning with examining the current AI landscape and projections of jobs impacted to understand organizational preparedness needs. Key elements include developing an ethical framework through stakeholder engagement outlining shared principles for responsibility; implementing comprehensive technical and soft-skills training programs; creating new dedicated ethics and data governance roles while expanding existing functions to oversee AI accountability; and integrating metrics and career pathways tied to system and process assessments through an ethical lens to drive cultural normalization. Continuous self-evaluation through qualitative and quantitative metrics aids transparency, justification of investment, and framework improvement. The goal of proactively cultivating stewardship abilities across all functions through values clarification, tailored learning, distributed responsibilities, and self-reflection is positioned as exemplary leadership guiding technology's societal impacts amid workplace transformations from emerging technologies.

How Can Newborn Toxicology Testing Be More Equitable? An Interactive Ethics Workshop.

Practice variation in newborn toxicology testing during the birth hospitalization exists across institutions and legal jurisdictions. While testing can provide benefits, indiscriminate testing has been shown to perpetuate health care inequities. In the backdrop of an opioid epidemic and a charged medicolegal landscape, this workshop guides participants to reexamine newborn toxicology testing through a shared ethical lens. We conducted a live, 90-minute workshop in English at an international pediatric conference. Physicians, residents, and fellows participated in large- and small-group breakout sessions to learn relevant clinical and bioethical frameworks, share their own local context and expertise, and explore ethical applications through case-based discussions. We administered two anonymous online follow-up surveys to assess self-perceived impact on participant knowledge, behavior, and clinical practice. Seven facilitators and 45 individuals participated in the workshop. Eighteen participants completed survey 1 immediately following workshop conclusion, and six participants completed survey 2 after 3 months had elapsed. Immediately following the workshop, 94% of respondents reported that they had been introduced to a new idea, and 82% were considering practice change. A low response rate to survey 2 limited interpretation, but some respondents reported self-perceived change following workshop attendance. This workshop facilitated conversation between physician participants on a complex pediatric health care inequity issue using an ethical framework.

Teaching ethics and ethical leadership with the Harvard Everest simulation

PurposeThis is a step-by-step guide for teaching Ethics and Ethical Leadership utilizing the Harvard Everest Leadership and Teams Simulation, V.3. The suggested approach is focused on facilitating a discussion and coaching students to recognize and solve problems by applying moral theory explicitly and deliberately. Applying this approach can also help them develop a habit of analyzing one’s own and others' behavior using ethical lenses and principles of authentic leadership. It offers practical debrief steps and specific discussion questions that can be used as a standalone resource or alongside the Harvard teaching note accompanying the simulation.Design/methodology/approachThis innovative approach enables teaching and coaching students on the ethical aspects of their leadership and decision-making based on this hands-on experience with the Harvard Everest Leadership and Teams Simulation. This approach enriches the original HBR teaching suggestions by enabling students to recognize moral dilemmas, confront typical rationalizations and practice ethical actions and decision-making in real time.FindingsIn-class discussion and student reflection assignments provide evidence of the method's effectiveness in translating values into impactful insights and enhanced likelihood of ethical behaviors in real-life scenarios. Students’ end-of-class feedback and course evaluations often cite the benefits of using the Everest simulation as a backdrop for raising self-awareness and practicing ethical decision-making.Practical implicationsThe approach discussed in the paper can serve as a flexible framework for analyzing and debriefing the HBR Everest simulation and other simulations, “survival scenario” exercises and activities designed to teach and facilitate practicing ethical leadership, authentic leadership and ethical decision making. It is adaptable and can be effectively applied across various disciplines centered around ethical leadership, teamwork, communication and decision-making in higher education and business.Originality/valueHarvard Everest Leadership and Teams Simulation is among the most popular ones in business education and is used by teachers worldwide (Roberto & Edmondson, 2017). While a comprehensive teaching note on communication and group dynamics is available through Harvard Business Publishing, it still needs to address the ethical issues students face during the simulation. This paper provides a roadmap for instructors who want to improve the student experience with ethical decision-making and ethical leadership.

National Security Intelligence Activity and the Just Intelligence Theory

National security intelligence (NSI) activity is considered through a normative (ethical) lens and the application of a normative theory to NSI collection, analysis, and dissemination undertaken. The currently favored normative theory is the Just Intelligence Theory (JIT), derived from the Just War Theory, applicable to waging war. Whereas JIT has provided a useful starting point to normative theorizing about NSI activity as well as several specific insights, it has several significant deficiencies as a general overarching normative theory of NSI activity and, therefore, should be abandoned by qua general theory. For instance, NSI activity is largely epistemic (or knowledge-focused) activity, whereas waging war is kinetic activity, and this has important ethical consequences, such as that the principle of last resort applicable to waging war is not applicable to NSI activity. Moreover, other principles, such as the principle of discrimination, are applicable in a radically different manner.

Political Organisational Silence and the Ethics of Care: EU Migrant Restaurant Workers in Brexit Britain

In this paper, we explore the experiences of EU migrants working in UK restaurants in the aftermath of the Brexit vote. We do so through a care ethics lens, which we bring together with the integrative approach to organisational silence to consider the ethical consequences of the organisational policies of political silence adopted by the restaurant chains in our qualitative empirical study. We develop the concept of political organisational silence and probe its ethical dimensions, showing how at the organisational level it falls short of constituting a practice of caring for migrant workers in politically divisive and hostile times. We argue that organisational policies of political silence emphasise the exploitative nature of the business of (im)migration, which prioritises concern for profits over care for the needs of others. Organisations refuse caring responsibility for migrant workers, leaving care to the migrants themselves and their co-workers and managers. Whilst peer-care practices partially fill this politically silent care-vacuum, this leaves individuals to negotiate difficult tensions without institutional support at a time of increased uncertainty, complexity, hostility, violence, and vulnerability. Drawing lessons from our study and its aftermath, we call for a care manifesto to inform the business of (im)migration, which would need to include caring political responsibility towards migrant workers exercised through caring political organisational voice as well as silence.

An ethics analysis of antipsychotic dose reduction and discontinuation: Principles for supporting recovery from psychosis.

To examine the evidence and practice of antipsychotic dose reduction from the lens of biomedical ethics (specifically principlism) to support evidence-based practice and patient choice and self-determination. An overview of the evidence from randomized controlled trials of antipsychotic dose reduction versus maintenance is presented. This is followed by a theoretical examination of the four key biomedical ethical principles of autonomy, nonmaleficence, beneficence, and justice and how they apply in the case of antipsychotic dose reduction. Existing clinical trial research is dominated by relapse as the primary outcome, with dose reduction associated with a higher risk of relapse than maintenance. Few studies have measured other patient-centered outcomes but have shown preliminary evidence for superior cognitive functioning, lower negative symptoms, and better functioning following dose reduction. Respect for autonomy is a cornerstone of psychiatric rehabilitation, and this includes the right of people to choose to reduce or discontinue antipsychotic medication. Reduced capacity for treatment decision making can be supported. Autonomy and appraisal of nonmaleficence and beneficence associated with dose reduction can be facilitated through shared or supported decision making. Clinicians should continue to strive for justice through the fair allocation of resources to support all people who request antipsychotic dose reduction. Clinicians have a responsibility to balance the four core ethical principles to the best of their ability when supporting a person in their recovery journey. Exploring, trialing, and supporting antipsychotic dose reduction may be part of this process if that is the patient's choice. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

EDI in academic–policy engagement: lived experience of university based knowledge brokers and marginalised academics

Background: Discourse surrounding Equality, Diversity and Inclusion (EDI) has received significant attention within the UK academy and knowledge brokerage contexts, and more recently within academic–policy engagement spaces (Walker et al, 2019a; Fawcett, 2021; GOV.UK, 2021; Morris et al, 2021). Key players in this space identify the need for diversifying academic participation, as well as diversifying knowledges (GOV.UK, 2021; UK Parliament, 2018; UKRI, 2023). However, conceptual and practical insight on embedding EDI principles (and what they mean in this context) within academic–policy engagement processes is missing. Aims and objectives: Underpinned by feminist and decolonial epistemological concepts, this article addresses this gap by outlining strategies, and surfacing ways in which EDI within academic–policy engagement is experienced, conceptualised, understood and considered. Methods: Two parallel qualitative studies, with a total of 20 semi-structured narrative and realist interviews conducted with marginalised researchers (n=10, Study A) and university based knowledge brokers (n=10, Study B), and a rapid literature review. The analysis used a narrative and thematic framework. Findings and discussion: We found a want for EDI to go beyond just diversity of people and representation, towards fostering foundational principles of epistemic justice, equitable access, value-driven engagement and plurality. Academics and knowledge brokers reported both negative and positive experiences within this space that related to known EDI issues. We conclude that EDI cannot be standardised across higher education contexts, and emphasise the need for holistic, relational and plural approaches to EDI across academic–policy engagement systems through a value-led, equitable and ethical lens.

Greatest Good for the Greatest Number – the Role of Managers’ Ethical Meaning-Making and Subjective Wellbeing Complexity

AbstractDespite the appeal of ‘the greatest good for the greatest number’ as an ethical ideal for businesses to pursue, applying this utilitarian principle in practice proves challenging. This is not least due to fundamental disagreements as to what constitutes the ‘greatest good.’ For example, the concept of ‘wellbeing’ now commonly proposed as a way of apprehending the greatest good is itself subject to widely varying interpretations. Drawing on an in-depth qualitative study of 64 managers in different sectors and country contexts, we explore this variation through the lens of constructivist ethics, asking how and why managers systematically differ in their ethical meaning-making around wellbeing. Our theorizing advances constructivist ethics by relating these differences to developmental stages identified in constructivist psychology, finding that systematic variations in ethical meaning-making are shaped by differences in actors’ capacities to process complexity. Our analysis reveals that managers’ ethical meaning-making about wellbeing is subjective, socially constructed, dynamic, and evolutionary, progressing in stages that we differentiate with a novel concept of ‘subjective wellbeing complexity.’ We contribute to practice by discussing how managers’ ability to work with more complex conceptions of wellbeing can be purposefully enhanced through stage-by-stage capacity-building in the form of ‘vertical development.’

Social Work Ethical Dilemma: Social Workers' Experiences in Handling Children Who Are Involved by Parents in Acts of Terrorism

Objectives: This research aims to explain the ethical dilemmas faced by social workers in handling children whose parents involve them in acts of terrorism.The study is grounded in the principles of values and ethics essential for social work professionalism. It examines ethical dilemmas through the lenses of deontological and teleological ethics, professional codes of ethics, and the balance between confidentiality, communication, and self-determination.A qualitative approach with a case study design was employed to explore natural phenomena in depth. Data were collected through in-depth interviews with four social workers directly involved in handling children whose parents involved them in acts of terrorism.The research found that social workers face significant ethical dilemmas, including balancing confidentiality and accessible communication, navigating professional and personal values, and managing self-determination versus paternalism. These dilemmas create confusion and impact the intervention process.The findings highlight the need for structured support for social workers, including guidance on ethical decision-making and opportunities for professional consultation. It suggests revisiting and reinforcing the professional code of ethics and discussing ethical challenges with colleagues and supervisors to navigate these dilemmas effectively.This study provides valuable insights into the specific ethical challenges encountered by social workers dealing with terrorism-related cases in Indonesia. It contributes to the body of knowledge by offering alternative solutions for ethical dilemmas, enhancing the understanding of the practical application of ethics in social work.

Readiness to change in Islamic banking: the significance of adaptability and Islamic work ethics

Purpose This paper aims to investigate Islamic work ethics and adaptability towards change readiness of Islamic Bank employees in Indonesia with commitment as a mediating variable. This study focuses on the Sharia banking industry, which is facing transformation from Sharia business units to Sharia commercial banks by preparing its human resources, thus minimizing resistance. Design/methodology/approach This study is based on a survey of 135 Bank Syariah Indonesia employees via an online questionnaire. PLS-SEM is used to analyze data and test hypotheses using SMART-PLS. Findings The results of the study show that adaptability does not have a positive and significant effect on readiness for change in Indonesian Sharia banks and organizational commitment. Meanwhile, Islamic work ethics have a positive and significant effect on the change readiness of Islamic bank employees in Indonesia as well as organizational commitment. This study also found that organizational commitment mediates the impact of Islamic work ethics on the change readiness of Islamic bank employees in Indonesia. Research limitations/implications This research uses a sample of employees at Sharia commercial banks (BUS) in Indonesia, so it is still limited to certain types of banks. Future research needs to test the model in different contexts, such as banks that still have Sharia business unit (UUS) status. In addition, further research needs to use other variables such as leader support for transformational change readiness. Future research also needs to control more variables and use a more complex scale than a binary scale (e.g. percentage of share ownership or area within a province or district/city). This study recommends that employee change readiness is very necessary to avoid resistance and resistance to the transformation and acceleration of Sharia banking in Indonesia. Originality/value This research looks at employee readiness for change in Indonesian Sharia banks through the lens of adaptability Islamic work ethics and organizational commitment.

On a wing and a prayer: professional ethics and the prison library

PurposeIn response to instrumental cultural policy agendas in the United Kingdom, the paper explores the practice of collaborative cultural work in the criminal justice system through the lens of professional ethics in prison libraries. It seeks to balance narratives on the value of arts and culture in cross-government policy agendas with a nuanced consideration of the realities of such work in non-conventional organisational settings.Design/methodology/approach“Instrumental Values: Professional ethics in collaborative cultural work” was a two-year empirical study (2017–2019), including ethnographic fieldwork in three case study sites representing prison library services in England. Following a “communities of practice” conceptual framework, research methods included participant observation of day-to-day cultural work and specific events; successive research interviews with library and prison service staff and volunteers; and interviews with key collaborating organisations from extended professional networks.FindingsData from three prison library case studies show consistent ethical implications relating to the extent of collaborative complexity in the field and its impact on participants’ emotional resilience; navigation of the prison regime by cultural workers; consequences for emotional labour and care in the field; and the re-negotiation of ethical boundaries and practices.Originality/valueThe research makes an original contribution to debates on the instrumental value of arts and culture via its intimate focus on prison libraries as microcosms of situated, truly integrated cultural work, both from a physical, organisational perspective and in their representation of a cross-policy function for arts and culture.

Virtue ethics and the unsettled ethical questions in controlled human infection studies.

Controlled human infection studies (CHIs) involve the intentional infection of human subjects for a scientific aim. Though some past challenge trials have involved serious ethical abuses, in the last few decades, CHIs have had a strong track record of safety. Despite increased attention to the ethics of CHIs during the COVID-19 pandemic, CHIs remain controversial, and there has been no in-depth treatment of CHIs through the lens of virtue ethics. In this article, we argue that virtue theory can be helpful for addressing CHIs that present a constellation of controversial, unresolved, and/or under-regulated ethical issues. We begin with some brief background on virtue ethics. We then substantiate our claim that some CHIs raise a constellation of ethical issues that are unresolved in the ethics literature and/or lack adequate regulatory guidance by demonstrating that CHIs can present indeterminate social value, risks to third parties, limitations on the right to withdraw from research, and questions about the upper limit of allowable risk. We argue that the presence of a virtuous investigator, with virtues such as prudence, compassion, and integrity, is especially important when these unresolved research ethics issues arise, which is the case for certain types of controlled human infection studies. We use the historical example of Walter Reed and the Yellow Fever Commission to illustrate this claim, and we also highlight some contemporary examples. We end by sketching some practical implications of our view, such as ensuring that investigators with experience running CHIs are involved in novel CHI models.

Consideration of student evaluations of teaching (SET) and learning: perspectives of learning and teaching leaders through the ethical lens of “first, do no harm”

This paper explores institutional leaders’ perceptions of learning and teaching involved in facilitating and assessing Student Evaluations of Teaching (SET) survey instruments across Australian regional universities. It focuses on how they understand the function of SET, strategies used to mitigate bias, and potential residual harm. Through adopting a combination of inductive and deductive research processes and a thematic analysis through the ethical lens of nonmaleficence (first, do no harm), we report that leaders in learning and teaching perceive SET as a form of surveillance and Quality Assurance ‘performance’, recognise inherent biases inhabited in SET reports, and identify how these biases negatively impact academics through a lack of systematic harm mitigation strategies. The paper’s critical – and novel – contributions include an increased understanding of how SET inflicts harm towards women and other marginalised academic groups through systematic and authorised microaggressions and how SET contravenes universities’ duty of care to employees. It recommends an expansion of the principle of nonmaleficence beyond potential harm to research subjects, including those who undertake research or evaluation (such as academics), particularly if these impact them.

Reassessing ‘good’ medical practice and the climate crisis

In August 2023, the General Medical Council released the latest update of Good Medical Practice, which sets out the standards of patient care and professional behaviour to be expected of...

Can Relational Ethics Guide Us in Wolf Management?

ABSTRACT This paper reevaluates wolf management through a relational ethics lens, highlighting the inadequacy of traditional wild versus domesticated categorizations. Recognizing the complexity of historical and ongoing human-wolf interactions, it proposes a nuanced, context-sensitive approach to ethical responsibilities toward wolves. By introducing an assessment process based on the examination of mutual impacts in human-wolf relations, this study advocates for a more informed and morally conscious management strategy that acknowledges wolves’ complex existence within human-affected landscapes.

Analyzing the Effectiveness of Non-remote Monitoring Telemedicine Within the United States After 2019, Including Future Implications as a Healthcare Medium, Regarding Its Statistical and Analytical Disciplines: A Systematic Review

Telemedicine is the utilization of healthcare services remotely via numerous applications that connect the patient with a qualified physician. Telemedicine plays a vital role in providing accessible healthcare to individuals who are unable to do an in-person visit, and its involvement in healthcare is analyzed through the analytical/statistical lens, financial lens, and ethical lens. Telemedicine systems have demonstrated their potential to serve as a functional healthcare medium, but many barriers to an increase in its implementation and efficacy still exist after the COVID-19 pandemic. Despite the importance of telemedicine, knowledge of its implied efficacy and efficiency in providing healthcare is poor, and already existing research doesn’t address solutions to the barriers of telemedicine. The research aims to address this gap by doing a comprehensive, systematic literature review on the efficacy, barriers to implementation, practicality, and future implications of telemedicine’s utilization in the healthcare sphere. Furthermore, by adding a unique perspective on this topic and consolidating research data for the general healthcare field to utilize, this further addresses missing medical knowledge regarding telemedicine consultations. This research screened 737 different articles and papers to gather information regarding telemedicine and its efficacy. Results were filtered and screened using the PRISMA method to maintain a standard of high-quality, impartial, and accurate data throughout the research paper. Only the sources which pertained to the research question were chosen to be included in the paper. Trends were identified in the chosen articles, which were viewed by the contributors and referenced in the paper. Telemedicine has demonstrated profound evidence of benefits for both patients and healthcare administrations. However, concerns regarding its accessibility and efficacy remain. Suggestions are made for medical administrations and for public knowledge to provide solutions for these concerns.