Editorial: Respect and Protect vulnerability: The role of Medical Law

- The theme of 2025 World Congress in Medical Law (WCML) held in Istanbul, Türkiye (Turkey) during the period 6 to 8 August is “Vulnerability in 21st Century: Respect and Protect”. - Plenary paper by Özsunay has described how Child’s Rights Convention and Oviedo Convention are integral parts of the current Turkish law with some national laws laying down protective measures for vulnerable people . - The well-established terms of “vulnerability” and “vulnerable persons in international law and national laws can help to clarify some sensitive issues related to medical law so “vulnerable persons” should be understood and defined in its widest content and not be limited only to “minors” and “vulnerable adults”, and can include others such as disabled people, elderly people, pregnant women, single parents with minor children, victims of trafficking in human beings, persons with serious illnesses, persons with mental disorders, persons who have been subjected to torture, rape or other forms of psychological, physical or sexual violence - Echoing the themes of 2025 WCML, this issue also include articles to address vulnerable population from wider perspectives. Victims of sexual violence or rape are vulnerable group. - Article by Bhaskar and Desikan has highlighted that sexual offenders share numerous similarities, particularly in their thought processes and behavioural patterns . - The article analyse the interplay of psychology and the law, based on the literature reporting the effectiveness of various therapies and strategies for relapse prevention, aiming to identify the effective approach for the administration and management of sexual offences and the handling of offenders to avoid sexual recidivism. - This is in line with the doctrine of public health emphasising on preventive care better than curative treatment. - People living in wartime are also vulnerable requiring protection by legislative measures. - Legislative change during wartime should do more than responding to challenges of medical care during wartime such as evacuation of patients, supporting medical care in military operations, protection of medical workers in the conflict zone, and provision of medical care to displaced persons and military veterans, and it should also pay special attention to protect the rights of patients, especially vulnerable categories such as children, the elderly, people with disabilities and displaced persons and rehabilitation of those affected by the war, including military veterans, displaced civilians, and healthcare workers as stated in the article by Turchina et al describing the wartime changes in medical law Ukraine . - The psychological trauma of war is often difficult of recovery so legislative framework should be developed to ensure integration of mental health services into the primary health care system for early intervention and continuous support. The recommendations by the article can enable Ukraine also other countries facing war conflicts to rebuild healthcare system that is more resilient and responsive to future emergencies. - Medical interventions are not without risk and patients should be safeguarded for the safety. Article by Beran (plenary presentation of 2025 WCML) calls for patient involvement in decision making upholding the ethical principles of beneficence and autonomy, and informed decisions necessitate being adequately informed including disclosure of “material risks” and right of refusal . - There are many regulations made in Turkish Medical Law regarding patient safety with Heath Professions Board vested with important duties to ensure patient safety as stated in the article by Hakeri (plenary presentation of 2025 WCML) . Sanctions of criminal law and compensation law will also be applied to healthcare professionals if the patient is harmed by negligent act of healthcare professionals under Turkish law . - Vulnerability should also cover issue such as rights to decide medical treatment being overridden by public interest such as mandatory vaccination. Mandatory vaccination for COVID-19 vaccination during pandemic has raised the delicate issue of balancing public and private interests. - Article by Roncati and Roncati raises the principle of legality and reasonableness should be constantly evaluated with the changing scientific by health policy makers so their decisions would depend on the current state of scientific evidence rather than prospective outcomes . - Surrogacy is a complex reproductive arrangement posing legal and ethical challenges in balancing the rights of intended parents’ parental rights and the reproductive autonomy of surrogate mothers particularly when the consent of surrogate mother is withdrawn during pregnancy. Both surrogate mother and intended mother can both be regarded as vulnerable persons as they are affected by pregnancy. - Article by Gosmasta et al has examined case studies, legal frameworks and ethical issues to provide a balanced strategy to protect the legitimate expectations of intended parents and also respecting the autonomy of surrogate . - The article suggests to use mediation as primary tool to resolve the disputes with a balanced approach for the surrogate, intending parents and medical practitioners enforcing the surrogacy contracts. - Emerging Artificial Intelligence (AI) technology in healthcare brings great advancement in patient care. However, one cannot under-estimate the complexity and challenges posed in patient safety. - Article by Johnson and Nevin has raised the issue that AI development is moving faster than regulators can keep pace and a holistic approach is needed with collaboration between different stakeholders to regulate, govern and oversee the ethical and safe use of AI in clinical care . - Medical technology has advanced rapidly bringing tremendous benefits to mankind. However, patients can also expose to greater risks with medical interventions unless patient safety is accorded higher priority. The concept of vulnerability should be defined in boarder and wider perspectives with changing socio-demographic and economic-political changes. - The presentations of the Conference ranged from more foundational areas to more specialized and contemporary topics and was able to see directly the application of various theories and methods to an area that will be always relevant to medical law .