Moral injury emerged in the healthcare discussion quite recently because of the difficulties and challenges healthcare workers and healthcare systems face in the context of the COVID-19 pandemic. Moral injury involves a deep emotional wound and is unique to those who bear witness to intense human suffering and cruelty. This article aims to synthesise the very limited evidence from empirical studies on moral injury and to discuss a better understanding of the concept of moral injury, its importance in the healthcare context and its relation to the well-known concept of moral distress. A scoping literature review design was used to support the discussion. Systematic literature searches conducted in April 2020 in two electronic databases, PubMed/Medline and PsychInfo, produced 2044 hits but only a handful of empirical papers, from which seven well-focused articles were identified. The concept of moral injury was considered under other concepts as well such as stress of conscience, regrets for ethical situation, moral distress and ethical suffering, guilt without fault, and existential suffering with inflicting pain. Nurses had witnessed these difficult ethical situations when faced with unnecessary patient suffering and a feeling of not doing enough. Some cases of moral distress may turn into moral residue and end in moral injury with time, and in certain circumstances and contexts. The association between these concepts needs further investigation and confirmation through empirical studies; in particular, where to draw the line as to when moral distress turns into moral injury, leading to severe consequences. Given the very limited research on moral injury, discussion of moral injury in the context of the duty to care, for example, in this pandemic settings and similar situations warrants some consideration.

Objective: This qualitative study aims to present the aspirations, expectations and critical analysis of the potential for artificial intelligence (AI) to transform patient–physician relationship, according to multi-stakeholder insight. Methods: This study was conducted from June to December 2021, using an anticipatory ethics approach and sociology of expectations as the theoretical frameworks. It focused mainly on three groups of stakeholders; namely, physicians (n = 12), patients (n = 15) and healthcare managers (n = 11), all of whom are directly related to the adoption of AI in medicine (n = 38). Results: In this study, interviews were conducted with 40% of the patients in the sample (15/38), as well as 31% of the physicians (12/38) and 29% of health managers in the sample (11/38). The findings highlight the following: (1) the impact of AI on fundamental aspects of the patient–physician relationship and the underlying importance of a synergistic relationship between the physician and AI; (2) the potential for AI to alleviate workload and reduce administrative burden by saving time and putting the patient at the centre of the caring process and (3) the potential risk to the holistic approach by neglecting humanness in healthcare. Conclusions: This multi-stakeholder qualitative study, which focused on the micro-level of healthcare decision-making, sheds new light on the impact of AI on healthcare and the potential transformation of patient–physician relationship. The results of the current study highlight the need to adopt a critical awareness approach to the implementation of AI in healthcare by applying critical thinking and reasoning. It is important not to rely solely upon the recommendations of AI while neglecting clinical reasoning and physicians’ knowledge of best clinical practices. Instead, it is vital that the core values of the existing patient–physician relationship – such as trust and honesty, conveyed through open and sincere communication – are preserved.

Pediatric access to exoskeletons lags far behind that of adults. In this article, we promote inclusiveness in exoskeleton robotics by identifying and addressing challenges and barriers to pediatric access to this potentially life-changing technology. We first present available exoskeleton solutions for upper and lower limbs and note the variability in the absence of these. Next, we query the possible reasons for this variability in access, explicitly focusing on children, who constitute a categorically vulnerable population, and also stand to benefit significantly from the use of this technology at this critical point in their physical and emotional growth. We propose the use of a life-based design approach as a way to address some of the design challenges and offer insights toward a resolution regarding market viability and implementation challenges. We conclude that the development of pediatric exoskeletons that allow for and ensure access to health-enhancing technology is a crucial aspect of the responsible provision of health care to all members of society. For children, the stakes are particularly high, given that this technology, when used at a critical phase of a child’s development, not only holds out the possibility of improving the quality of life but also can improve the long-term health prospects.

Digital phenotyping represents an avenue of consideration in patients' self-management. This scoping review aims to explore the trends in the body of literature on ethical, legal, and social challenges relevant to the implementation of digital phenotyping technologies in healthcare. The study followed the PRISMA-ScR methodology (Tricco et al. in Ann Int Med 169(7):467–473, 2018.https://doi.org/10.7326/M18-0850). The review systematically identified relevant literature, characterised the discussed technology, explored its impacts and the proposed solutions to identified challenges. Overall, the literature, perhaps unsurprisingly, concentrates on technical rather than ethical, legal, and social perspectives, which limits understanding of the more complex cultural and social factors in which digital phenotyping technologies are embedded. ELS issues mostly concern privacy, security, consent, lack of regulation, and issues of adoptability, and seldom expand to more complex ethical issues. Trust was chosen as an umbrella theme of a continuum of major ELS and technical issues. Sustained critical analysis of digital phenotyping showed to be sparse and geographically exclusive. There is a continuum and overlap between ELS issues, suggesting the need for a holistic, interdisciplinary approach to each of the challenges posed by the various technologies of digital phenotyping.