Physician-researchers are bound by professional obligations stemming from both the role of the physician and the role of the researcher. Currently, the dominant models for understanding the relationship between physician-researchers' clinical duties and research duties fit into three categories: the similarity position, the difference position and the middle ground. The law may be said to offer a fourth "model" that is independent from these three categories.These models frame the expectations placed upon physician-researchers by colleagues, regulators, patients and research participants. This paper examines the extent to which the data from semi-structured interviews with 30 physician-researchers at three major pediatric hospitals in Canada reflect these traditional models. It seeks to determine the extent to which existing models align with the described lived experience of the pediatric physician-researchers interviewed.Ultimately, we find that although some physician-researchers make references to something like the weak version of the similarity position, the pediatric-researchers interviewed in this study did not describe their dual roles in a way that tightly mirrors any of the existing theoretical frameworks. We thus conclude that either physician-researchers are in need of better training regarding the nature of the accountability relationships that flow from their dual roles or that models setting out these roles and relationships must be altered to better reflect what we can reasonably expect of physician-researchers in a real-world environment.

Background Medical innovations offer tremendous hope. Yet, similar innovations in governance (law, policy, ethics) are likely necessary if society is to realize medical innovations’ fruits and avoid their pitfalls. As innovations in artificial intelligence (AI) advance at a rapid pace, scholars across multiple disciplines are articulating concerns in health-related AI that likely require legal responses to ensure the requisite balance. These scholarly perspectives may provide critical insights into the most pressing challenges that will help shape and advance future regulatory reforms. Yet, to the best of our knowledge, there is no comprehensive summary of the literature examining legal concerns in relation to health-related AI. We thus aim to summarize and map the literature examining legal concerns in health-related AI using a scoping review approach. Methods The scoping review framework developed by (J Soc Res Methodol 8:19-32, 2005) and extended by (Implement Sci 5:69, 2010) and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews (PRISMA-ScR) guided our protocol development. In close consultation with trained librarians, we will develop a highly sensitive search for MEDLINE® (OVID) and adapt it for multiple databases designed to comprehensively capture texts in law, medicine, nursing, pharmacy, other healthcare professions (e.g., dentistry, nutrition), public health, computer science, and engineering. English- and French-language records will be included if they examine health-related AI, describe or prioritize a legal concern in health-related AI or propose a solution thereto, and were published in 2012 or later. Eligibility assessment will be conducted independently and in duplicate at all review stages. Coded data will be analyzed along themes and stratified across discipline-specific literatures. Discussion This first-of-its-kind scoping review will summarize available literature examining, documenting, or prioritizing legal concerns in health-related AI to advance law and policy reform(s). The review may also reveal discipline-specific concerns, priorities, and proposed solutions to the concerns. It will thereby identify priority areas that should be the focus of future reforms and regulatory options available to stakeholders in reform processes. Trial registration This protocol was submitted to the Open Science Foundation registration database. See https://osf.io/zav7w.

Two major trends have developed in pediatric bioethics: family-centered care and increased recognition of emerging autonomy through legal and policy entrenched rights. The different foci of their corresponding health care delivery models ("family-centered" or "patient-/child-centered") create the potential for conflict in the context of seeking consent to research or, as will be presented, the possibility of integration. Given the state of current bioethical principles and legal holdings, the pediatric patient should ultimately be the primary focus of ethical consideration and, at least in the context of dissenting to research, the child's autonomous wishes should reign. However, in recognizing and supporting a child's emerging autonomy, the family context should also be respected and taken into account. This discussion articulates the values underpinning these two important trends in pediatric health care delivery, and proposes a model for obtaining consent for pediatric research in the current context.

Federalism has important implications for basic philosophical concepts, including authority and distributive justice. Philosophers played key roles in the development of federalism as a(n at least purportedly) normative doctrine. However, federalism remains peripheral in contemporary political philosophy, leading to periodic calls for renewed scrutiny. This article identifies questions that any complete philosophical account of federalism should aim to answer and provides an overview of some dominant responses to those questions offered in contemporary work in law, political science, and the nascent contemporary philosophical work on the doctrine. It first explains why federalism should be considered philosophically important. It then explores issues about the meaning and purpose, paradigm cases, institutional implications, and subjects/objects of federalism. It finally highlights the need to explain federalism's relationships to adjacent concepts, like democracy, subsidiarity, and self‐determination, and possible links between them.

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