Nikola Biller‐Andorno
Biographic Data
| ID | 6703432 |
|---|---|
| NAME | Nikola Biller‐Andorno |
| GIVEN NAMES | Nikola |
| FAMILY NAME | Biller‐Andorno |
| SIGNATURE | ANDORNO N B |
| AFFILIATIONS | University of Zurich |
| ORCID | 0000-0001-7661-1324 |
| VERIFIED | Yes |
| TOTAL WORKS | 40 |
| TOTAL CITATIONS | 11 |
| AUTHOR COUNT | 40 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2001 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 2 |
An International Delphi Study on the Challenges of Self-Experimentation for Medical Research Ethics
Self-experimentation is a research practice that might advance scientific progress and benefit populations worldwide. However, it also carries risks, both in terms of potential harm to researchers and the possibility of undermining research. This study seeks to explore expert perspectives on self-experimentation, examining its potential benefits and risks, identifying areas of consensus and divergence, and highlighting key themes to inform debate…
Perceptions and misconceptions of PSA screening in Switzerland
PSA screening for prostate cancer remains controversial due to the trade-offs between potential benefits and harms, particularly overdiagnosis and overtreatment. This study applies a preference epidemiology approach to explore how individuals evaluate these trade-offs and identify thresholds at which screening is perceived as acceptable or burdensome. We examined both personal and societal perspectives on PSA screening to better understand the ro…
Moral contentions in the Covid-19 discourses
Moral Key Terms (MKTs) have been used in public discourses to challenge or support efforts to manage COVID-19. We developed four themes that illustrate this through a theory-driven qualitative content analysis of a dataset consisting of newspaper articles, social media posts, and responses from the online platform PubliCo. MKTs were used to contend how democratic decisions are legitimately formed, how to balance safety and freedom, how to foster …
Mastering critical thinking skills is strongly associated with the ability to recognize fakeness and misinformation
Introduction In the current era of digital information overload, individuals are inundated with content of varying quality and truthfulness. Critical evaluation of such content is essential to distinguish between legitimate information and misinformation or fakeness. Despite this need, there is limited empirical evidence on the effectiveness of training in critical thinking skills for enhancing such discernment. Methods This study operationalized…
The role of social justice in triage revisited
Saving as many lives as possible while ensuring equity for vulnerable groups through access to triage resources has been the dominant position since the onset of the COVID-19 pandemic in 2020. However, the exact relationship between the principles of social justice and efficiency remains a controversial and unresolved issue. In this paper, we aim to systematically distinguish between different models of this relationship and show that conceptuali…
On Religious Influence in Bioethics
The World Congress of Bioethics held in Qatar in 2024 (WCB 2024) sparked controversy around the role of religion in bioethics, highlighting the need for critical discussions. During the congress, there was a strong push for incorporating religious values into bioethical discourse, raising questions about the validity and implications of such an approach. This paper examines the influence of religious thought on bioethical discussions, and the ong…
Bioethics challenges in times of war
An International Comparison of Psychiatric Advance Directive Policy
The present work provides a comparative policy review of psychiatric advance directives, considering 1) variation across eleven international jurisdictions and 2) differentiation from other advance directive policy. The aim is to support well-founded legal and clinical practice when it comes to psychiatric advance directives by 1) clarifying the range of present approaches and 2) highlighting differential treatment of those with mental health con…
Differential treatment of individuals with mental health conditions in high-consequence decision-making
While both assisted suicide and advance directives relate to potentially high-consequence decision-making, the procedures for assisted suicide requests and expressing preferences through an advance directive typically place such processes outside of acute, emergency scenarios. These contexts allow for the decisions to be well-considered. As such, assisted suicide for individuals with mental health conditions and psychiatric advance directives pre…
Digital twins for children with rare diseases
The digital twin concept promises to revolutionize all dimensions of the health sector, including healthcare planning and delivery, health promotion and education, and medical research. The present article maps the key legal and ethical challenges which will need to be addressed for a successful roll-out of digital twin models for children living with rare diseases, using the example of phenylketonuria (PKU) as model disease. The main legal chall…
Healthcare providers' advocacy approaches and ethical challenges in delivering healthcare to undocumented migrants
Delivering healthcare to undocumented migrants presents a complex challenge for healthcare providers. Integrating advocacy efforts into their daily practices can be ambiguous in practical terms, stemming from the intricate task of addressing the health needs of this population while simultaneously advocating for their health rights within the constraints imposed on them. This study seeks to consolidate findings from literature regarding the advoc…
Large language models in medical ethics
Large language models (LLMs) have now entered the realm of medical ethics. In a recent study, Balas et al examined the performance of GPT-4, a commercially available LLM, assessing its performance in generating responses to diverse medical ethics cases. Their findings reveal that GPT-4 demonstrates an ability to identify and articulate complex medical ethical issues, although its proficiency in encoding the depth of real-world ethical dilemmas re…
International expert meeting on the donation and use of human milk
Where a mother's own milk is not available or is insufficient, donor human milk (DHM) processed by a human milk bank (HMB) is the recommended next best alternative. HMBs exist in over 65 countries. However, most countries have yet to establish national policies or programmes that support the provision of DHM. In July 2019, a group of international experts in fields relevant to human milk banking gathered at a meeting organised by the Institute of…
‘VaxTax’
Equal access to vaccines has been one of the key ethical challenges during the COVID-19 pandemic. Most scholars consider the massive purchase and hoarding of vaccines by high-income countries, especially at the beginning of the pandemic, to be unjust towards the vulnerable living in low-income countries. A recent proposal by Andreas Albertsen of a vaccine tax has been put forward to remedy this problem. Under such a scheme, high-income countries …
AI knows best? Avoiding the traps of paternalism and other pitfalls of AI-based patient preference prediction
Ethics of the algorithmic prediction of goal of care preferences
Artificial intelligence (AI) systems are quickly gaining ground in healthcare and clinical decision-making. However, it is still unclear in what way AI can or should support decision-making that is based on incapacitated patients’ values and goals of care, which often requires input from clinicians and loved ones. Although the use of algorithms to predict patients’ most likely preferred treatment has been discussed in the medical ethics literatur…
Black box algorithms in mental health apps
Mental health apps bring unprecedented benefits and risks to individual and public health. A thorough evaluation of these apps involves considering two aspects that are often neglected: the algorithms they deploy and the functions they perform. We focus on mental health apps based on black box algorithms, explore their forms of opacity, discuss the implications derived from their opacity, and propose how to use their outcomes in mental healthcare…
A critical analysis of national dementia care guidances
Adopting an ethics and human rights lens, this paper provides a critical analysis of national dementia care guidance from countries ranked highly in providing quality of care towards the end-of-life, including Australia, Ireland, New Zealand, Switzerland, Taiwan and the United Kingdom. The aim of this paper is to determine areas of consensus and disagreement among guidance and to understand current gaps in research. Overall, studied guidances sho…
Charity or empowerment? The role of Covax for low and middle‐income countries
What has the past reaction to the COVID‐19 pandemic taught us? We have seen that many low and middle‐income countries (LMICs) still lack access to vaccines, and it seems little progress has been made in the last few months and year. This article discusses whether the current strategies, most notably, vaccine donations by the international community and the COVID‐19 global access facility COVAX, offer meaningful solutions to tackle the problem. At…
Aneurysmal Subarachnoid Hemorrhage and Clinical Decision-Making
Overall, aSAH was perceived as a life-threatening event with various challenges depending on severity. The results suggest the need for tools that aid decision-making and better prepare AFs and NoK using accessible means and at an early stage
Economic sanctions, healthcare and the right to health
Sanctions are increasingly used by national states and the international community to put economic and political pressure on target countries, with the aim of effecting a shift in foreign or internal policies. In this paper, we argue that sanctions should never be imposed on healthcare products—diagnostic, curative or preventive—or on any other good or service that can be reasonably expected to entail direct negative consequences on access to hea…
Revisiting respect for persons
In everyday conversations, professional codes, policy debates, and academic literature, the concept of respect is referred to frequently. Bioethical arguments in recent decades equate the idea of respect for persons with individuals who are capable of autonomous decision-making, with the focus being explicitly on ‘autonomy,’ ‘capacity,’ or ‘capability.’ In much of bioethics literature, respect for persons is replaced by respect for autonomy. Thou…
AI support for ethical decision-making around resuscitation
Artificial intelligence (AI) systems are increasingly being used in healthcare, thanks to the high level of performance that these systems have proven to deliver. So far, clinical applications have focused on diagnosis and on prediction of outcomes. It is less clear in what way AI can or should support complex clinical decisions that crucially depend on patient preferences. In this paper, we focus on the ethical questions arising from the design,…
First Insights into Barriers and Facilitators from the Perspective of Persons with Multiple Sclerosis
Multiple Sclerosis (MS) is a complex, lifelong disease. Its effects span across different areas of life and vary strongly. In Switzerland, there is an intense discussion on how to optimize quality of care and patient safety. Patients should be more involved in the management of health care to improve the quality of care from the patient's perspective and form a more comprehensive perspective. This multiple-case study explores the question of how …
Supporting value sensitivity in the humanitarian use of drones through an ethics assessment framework
The current humanitarian use of drones is focused on two applications: disaster mapping and medical supply delivery. In response to the growing interest in drone deployment in the aid sector, we sought to develop a resource to support value sensitivity in humanitarian drone activities. Following a bottom-up approach encompassing a comprehensive literature review, two empirical studies, a review of guidance documents, and consultations with expert…
Hymen reconstruction as pragmatic empowerment? Results of a qualitative study from Tunisia
Are our data ready for the next global challenges? Resilient data for resilient societies and economies
COVID-19 has shaken a wide range of national systems and infrastructures, including health, welfare, environment or security. • The related challenges cannot be tackled in isolation as all parts of the systems are tightly interlocked and interdependent. • Addressing scenarios emerging from these interlocking challenges require transversal approaches and agile public policies. • Yet, approaches and policies depend on a steady, continuous supply of…
Communities and Clinical Trials
When clinical trials enter human communities, two complex systems merge-creating challenges for the clinical trial team and the local human community. This is of particular relevance for clinical trials in low-resource settings where the resource scarcity can intensify existing inequities. Here we present a case study of a phase III malaria vaccine clinical trial. Through qualitative interviews with researchers and caregivers of pediatric partici…
Case Study
Ms. Bach is a thirty-eight-year-old professional artist with diabetes and end stage renal disease. She has been on dialysis for a little over a year and is on a waiting list to receive a cadaveric kidney, but transplantation is not likely for at least three years. No family member or friend has volunteered as a living donor. Although she tolerates dialysis quite well, she says it causes her such psychological distress that it may drive her to com…
The Ethics of Evidence
Basing normative judgment and policy on a rich empirical account of the issue at hand is usually a good idea. But doing nothing and awaiting further evidence can sometimes itself be bad judgment. This is the case with female genital cutting. We already know what is needed to define the conditions under which female genital cutting is morally unacceptable and that we can legitimately act on this knowledge
Vulnerability and exploitation in a globalized world
Bioethics has changed considerably over the last few years. Increased global interaction, through the off-shoring of clinical trials, cross-border surrogacy, organ trafficking, and medical tourism, among others practices, has brought additional considerations to a discipline that has been, until recently, relatively contained within national borders. We aim to contribute to the discourse on exploitation and vulnerability in a way that reflects su…
Ethical Implications of Case‐Based Payment in C hina
How health care providers are paid affects how medicine is practiced. It is thus important to assess provider payment models not only from the economic perspective but also from the ethical perspective. C hina recently started to reform the provider payment model in the health care system from fee‐for‐service to case‐based payment. This paper aims to examine this transition from an ethical perspective. We collected empirical studies on the impact…
Different Understandings of Life as an Opportunity to Enrich the Debate About Synthetic Biology
Hymen reconstruction as pragmatic empowerment? Results of a qualitative study from Tunisia
Conflicting Priorities Between Risk Management and Treatment of Schizophrenia in Swiss Forensic Services—A Case Report
The Swiss Criminal Code provides measures for mentally-ill offenders focusing on their need for treatment. This may lead to the deprivation of the patient's liberty up to several years. Under certain circumstances the mentally-ill offender can be sentenced to an indefinite incarceration. This case presentation we will describe a forensic psychiatric patient diagnosed with schizophrenia who was ordered an indefinite incarceration in Switzerland af…
Decision-making capacity
Recommendations on Covid‐19 triage
On March 11, 2020 the World Health Organization classified COVID‐19, caused by Sars‐CoV‐2, as a pandemic. Although not much was known about the new virus, the first outbreaks in China and Italy showed that potentially a large number of people worldwide could fall critically ill in a short period of time. A shortage of ventilators and intensive care resources was expected in many countries, leading to concerns about restrictions of medical care an…
I Don’t Want to Do Anything Bad.” Perspectives on Scientific Responsibility
Communities and Clinical Trials
When clinical trials enter human communities, two complex systems merge-creating challenges for the clinical trial team and the local human community. This is of particular relevance for clinical trials in low-resource settings where the resource scarcity can intensify existing inequities. Here we present a case study of a phase III malaria vaccine clinical trial. Through qualitative interviews with researchers and caregivers of pediatric partici…
Building a multisystemic understanding of societal resilience to the Covid-19 pandemic
The current global systemic crisis reveals how globalised societies are unprepared to face a pandemic. Beyond the dramatic loss of human life, the COVID-19 pandemic has triggered widespread disturbances in health, social, economic, environmental and governance systems in many countries across the world. Resilience describes the capacities of natural and human systems to prevent, react to and recover from shocks. Societal resilience to the current…
Compulsory Interventions in Severe and Persistent Mental Illness
Background: Some psychiatric patients develop severe and persistent mental illness (SPMI), which, for a variety of reasons, can be therapy-refractory. Sometimes, treatment is not considered helpful by the patients themselves and does not improve their subjective quality of life. Furthermore, many SPMI patients experience compulsory interventions such as seclusion, restraint, or treatment against their will, which can cause harm. Methods: In a cro…
Parkinson’s Disease and Deep Brain Stimulation Have an Impact on My Life
Parkinson's disease (PD) has a large impact on patients' physical and mental health, which also greatly affects their family caregivers. Deep brain stimulation (DBS) has emerged as an effective treatment for PD, but different authors have expressed their concerns about the potential impact of DBS on personality and identity. Our study aims at better understanding how patients and family caregivers experience life with PD and DBS, the impact of bo…
Economic sanctions, healthcare and the right to health
Sanctions are increasingly used by national states and the international community to put economic and political pressure on target countries, with the aim of effecting a shift in foreign or internal policies. In this paper, we argue that sanctions should never be imposed on healthcare products—diagnostic, curative or preventive—or on any other good or service that can be reasonably expected to entail direct negative consequences on access to hea…
Revisiting respect for persons
In everyday conversations, professional codes, policy debates, and academic literature, the concept of respect is referred to frequently. Bioethical arguments in recent decades equate the idea of respect for persons with individuals who are capable of autonomous decision-making, with the focus being explicitly on ‘autonomy,’ ‘capacity,’ or ‘capability.’ In much of bioethics literature, respect for persons is replaced by respect for autonomy. Thou…
AI support for ethical decision-making around resuscitation
Artificial intelligence (AI) systems are increasingly being used in healthcare, thanks to the high level of performance that these systems have proven to deliver. So far, clinical applications have focused on diagnosis and on prediction of outcomes. It is less clear in what way AI can or should support complex clinical decisions that crucially depend on patient preferences. In this paper, we focus on the ethical questions arising from the design,…
First Insights into Barriers and Facilitators from the Perspective of Persons with Multiple Sclerosis
Multiple Sclerosis (MS) is a complex, lifelong disease. Its effects span across different areas of life and vary strongly. In Switzerland, there is an intense discussion on how to optimize quality of care and patient safety. Patients should be more involved in the management of health care to improve the quality of care from the patient's perspective and form a more comprehensive perspective. This multiple-case study explores the question of how …
Supporting value sensitivity in the humanitarian use of drones through an ethics assessment framework
The current humanitarian use of drones is focused on two applications: disaster mapping and medical supply delivery. In response to the growing interest in drone deployment in the aid sector, we sought to develop a resource to support value sensitivity in humanitarian drone activities. Following a bottom-up approach encompassing a comprehensive literature review, two empirical studies, a review of guidance documents, and consultations with expert…
Are our data ready for the next global challenges? Resilient data for resilient societies and economies
COVID-19 has shaken a wide range of national systems and infrastructures, including health, welfare, environment or security. • The related challenges cannot be tackled in isolation as all parts of the systems are tightly interlocked and interdependent. • Addressing scenarios emerging from these interlocking challenges require transversal approaches and agile public policies. • Yet, approaches and policies depend on a steady, continuous supply of…
‘VaxTax’
Equal access to vaccines has been one of the key ethical challenges during the COVID-19 pandemic. Most scholars consider the massive purchase and hoarding of vaccines by high-income countries, especially at the beginning of the pandemic, to be unjust towards the vulnerable living in low-income countries. A recent proposal by Andreas Albertsen of a vaccine tax has been put forward to remedy this problem. Under such a scheme, high-income countries …
AI knows best? Avoiding the traps of paternalism and other pitfalls of AI-based patient preference prediction
Ethics of the algorithmic prediction of goal of care preferences
Artificial intelligence (AI) systems are quickly gaining ground in healthcare and clinical decision-making. However, it is still unclear in what way AI can or should support decision-making that is based on incapacitated patients’ values and goals of care, which often requires input from clinicians and loved ones. Although the use of algorithms to predict patients’ most likely preferred treatment has been discussed in the medical ethics literatur…
Black box algorithms in mental health apps
Mental health apps bring unprecedented benefits and risks to individual and public health. A thorough evaluation of these apps involves considering two aspects that are often neglected: the algorithms they deploy and the functions they perform. We focus on mental health apps based on black box algorithms, explore their forms of opacity, discuss the implications derived from their opacity, and propose how to use their outcomes in mental healthcare…
A critical analysis of national dementia care guidances
Adopting an ethics and human rights lens, this paper provides a critical analysis of national dementia care guidance from countries ranked highly in providing quality of care towards the end-of-life, including Australia, Ireland, New Zealand, Switzerland, Taiwan and the United Kingdom. The aim of this paper is to determine areas of consensus and disagreement among guidance and to understand current gaps in research. Overall, studied guidances sho…
Political science (24 works) · Medicine (23 works) · Psychology (22 works) · Law (18 works) · Computer Science (14 works) · Health care (11 works) · Social Psychology (11 works) · Sociology (11 works) · Business (8 works) · Palliative Care and End-of-Life Issues (8 works)