W niniejszym artykule przedstawiliśmy filozoficzną argumentację na rzecz definicji doradztwa filozoficznego opracowaną przez Polskie Towarzystwo Doradztwa Filozoficznego. Omawiana profesja została pokazana jako forma ponowoczesnego poradnictwa dialogowego opierająca się na procesie filozofowania. Filozofowanie rozumiane jest przez nas zarówno jako forma pracy logiczno-analitycznej jak i towarzyszenie klientowi poprzez uważną obecność. Obecność ta warunkuje możliwość zadawania pytań o charakterze egzystencjalnym, umożliwia lepsze poznanie siebie, odnalezienie swojej filozofii życia oraz poszerzenie rozumienia podejmowanych kwestii. Zaprezentowaliśmy też metodykę pracy doradcy filozoficznego. Zaakcentowane zostały także niezbędne kompetencje, (...) które posiadać powinien doradca filozoficzny. (shrink)

There are no egalitarians in a pandemic. The scale of the challenge for health systems and public policy means that there is an ineluctable need to prioritize the needs of the many. It is impossible to treat all citizens equally, and a failure to carefully consider the consequences of actions could lead to massive preventable loss of life. In a pandemic there is a strong ethical need to consider how to do most good overall. Utilitarianism is an influential moral theory (...) that states that the right action is the action that is expected to produce the greatest good. It offers clear operationalizable principles. In this paper we provide a summary of how utilitarianism could inform two challenging questions that have been important in the early phase of the pandemic: (a) Triage: which patients should receive access to a ventilator if there is overwhelming demand outstripping supply? (b) Lockdown: how should countries decide when to implement stringent social restrictions, balancing preventing deaths from COVID‐19 with causing deaths and reductions in well‐being from other causes? Our aim is not to argue that utilitarianism is the only relevant ethical theory, or in favour of a purely utilitarian approach. However, clearly considering which options will do the most good overall will help societies identify and consider the necessary cost of other values. Societies may choose either to embrace or not to embrace the utilitarian course, but with a clear understanding of the values involved and the price they are willing to pay. (shrink)

In an article in this journal, Christopher Cowley argues that we have ‘misunderstood the special nature of medicine, and have misunderstood the motivations of the conscientious objectors’. We have not. It is Cowley who has misunderstood the role of personal values in the profession of medicine. We argue that there should be better protections for patients from doctors' personal values and there should be more severe restrictions on the right to conscientious objection, particularly in relation to assisted dying. We argue (...) that eligible patients could be guaranteed access to medical services that are subject to conscientious objections by: removing a right to conscientious objection; selecting candidates into relevant medical specialities or general practice who do not have objections; demonopolizing the provision of these services away from the medical profession. (shrink)

In this paper, we investigate how data about public preferences may be used to inform policy around the use of controversial novel technologies, using public preferences about autonomous vehicles (AVs) as a case study. We first summarize the recent ‘Moral Machine’ study, which generated preference data from millions of people regarding how they think AVs should respond to emergency situations. We argue that while such preferences cannot be used to directly inform policy, they should not be disregarded. We defend an (...) approach that we call ‘Collective Reflective Equilibrium in Practice’ (CREP). In CREP, data on public attitudes function as an input into a deliberative process that looks for coherence between attitudes, behaviours and competing ethical principles. We argue that in cases of reasonable moral disagreement, data on public attitudes should play a much greater role in shaping policies than in areas of ethical consensus. We apply CREP to some of the global preferences about AVs uncovered by the Moral Machines study. We intend this discussion both as a substantive contribution to the debate about the programming of ethical AVs, and as an illustration of how CREP works. We argue that CREP provides a principled way of using some public preferences as an input for policy, while justifiably disregarding others. (shrink)

It may soon be possible to generate human organs inside of human-pig chimeras via a process called interspecies blastocyst complementation. This paper discusses what arguably the central ethical concern is raised by this potential source of transplantable organs: that farming human-pig chimeras for their organs risks perpetrating a serious moral wrong because the moral status of human-pig chimeras is uncertain, and potentially significant. Those who raise this concern usually take it to be unique to the creation of chimeric animals with (...) ‘humanised’ brains. In this paper, we show how that the same style of argument can be used to critique current uses of non-chimeric pigs in agriculture. This reveals an important tension between two common moral views: that farming human-pig chimeras for their organs is ethically concerning, and that farming non-chimeric pigs for food or research is ethically benign. At least one of these views stands in need of revision. (shrink)

According to the free energy principle all living systems aim to minimise free energy in their sensory exchanges with the environment. Processes of free energy minimisation are thus ubiquitous in the biological world. Indeed it has been argued that even plants engage in free energy minimisation. Not all living things however feel alive. How then did the feeling of being alive get started? In line with the arguments of the phenomenologists, I will claim that every feeling must be felt by (...) someone. It must have mineness built into it if it is to feel a particular way. The question I take up in this paper asks how mineness might have arisen out of processes of free energy minimisation, given that many systems that keep themselves alive lack mineness. The hypothesis I develop in this paper is that the life of an organism can be seen as an inferential process. Every living system embodies a probability distribution conditioned on a model of the sensory, physiological, and morphological states that are highly probably given the life it leads and the niche it inhabits. I argue for an ecological and enactive interpretation of free energy. I show how once the life of an organism reaches a certain level of complexity mineness emerges as an intrinsic part of the process of life itself. (shrink)

Following a brief reconstruction of Hutto & Satne’s paper we focus our critical comments on two issues. First we take up H&S’s claim that a non-representational form of ur-intentionality exists that performs essential work in setting the scene for content-involving forms of intentionality. We will take issue with the characterisation that H&S give of this non-representational form of intentionality. Part of our commentary will therefore be aimed at motivating an alternative account of how there can be intentionality without mental content, (...) which we have called skilled intentionality. Skilled intentionality is the individual’s selective openness and responsiveness to a rich landscape of affordances.A second issue we take up concerns the distinction between ur-intentionality and content-involving intentionality. We will argue that our notion of skilled intentionality as it is found in humans cuts across these two categories. Instead of distinguishing between different forms of intentionality we recommend focusing on how skilled intentionality takes different forms in different forms of life. (shrink)

The precautionary principle aims to influence decision‐making in contexts where some activity poses uncertain but potentially grave threats. This perfectly describes the controversy surrounding germline gene editing. This article considers whether the precautionary principle should influence how we weigh the risks and benefits of human germline interventions, focusing especially on the possible threats to the health of future generations. We distinguish between several existing forms of the precautionary principle, assess their plausibility and consider their implications for the ethics of germline (...) modification. We also offer a novel form of the precautionary principle: the sufficientarian precautionary principle. Some plausible versions of the precautionary principle recommend placing somewhat greater weight on avoiding threats to future generations than on achieving short‐term benefits. However, no plausible versions of the precautionary principle entail that we should outright reject the use germline gene editing in human reproduction and some, such as the sufficientarian version, might endorse its use. (shrink)

AI researchers have developed sophisticated language models capable of generating paragraphs of 'synthetic text' on topics specified by the user. While AI text generation has legitimate benefits, it could also be misused, potentially to grave effect. For example, AI text generators could be used to automate the production of convincing fake news, or to inundate social media platforms with machine-generated disinformation. This paper argues that AI text generators should be conceptualised as a dual-use technology, outlines some relevant lessons from earlier (...) debates on dual-use life sciences research, and calls for closer collaboration between ethicists and the machine learning community to address AI language models’ dual-use implications. (shrink)

Human‐animal chimeras—creatures composed of a mix of animal and human cells—have come to play an important role in biomedical research, and they raise ethical questions. This article focuses on one particularly difficult set of questions—those related to the moral status of human‐animal chimeras with brains that are partly or wholly composed of human cells. Given the uncertain effects of human‐animal chimera research on chimeric animals’ cognition, it would be prudent to ensure we do not overlook or underestimate their moral status. (...) However, to assess moral status, we first need to determine what kinds of capacities are morally relevant. The standard view holds that it matters, morally, if chimeric animals develop uniquely human cognitive capacities. I argue that this view is mistaken, highlighting three problems with it: that we can think of examples of uniquely human cognitive capacities that are not morally significant, that we can think of examples of morally significant cognitive capacities that are not uniquely human, and that evidence that some cognitive capacity is shared with nonhuman animals does not undermine claims that this capacity is morally significant. We need a better framework for thinking about the moral status of part‐human beings. (shrink)

Cognition has traditionally been understood in terms of internal mental representations, and computational operations carried out on internal mental representations. Radical approaches propose to reconceive cognition in terms of agent-environment dynamics. An outstanding challenge for such a philosophical project is how to scale-up from perception and action to cases of what is typically called ‘higher-order’ cognition such as linguistic thought, the case we focus on in this paper. Perception and action are naturally described in terms of agent-environment dynamics, but can (...) a person’s thoughts about absent, abstract or counterfactual states of affairs also be accounted for in such terms? We argue such a question will seem pressing so long as one fails to appreciate how richly resourceful the human ecological niche is in terms of the affordances it provides. The explanatory work that is supposedly done by mental representations in a philosophical analysis of cognition, can instead be done by looking outside of the head to the environment structured by sociomaterial practices, and the affordances it makes available. Once one recognizes how much of the human ecological niche has become structured by activities of talking and writing, this should take away at least some of the motivation for understanding linguistic thinking in terms of content-bearing internal representations. We’ll argue that people can think about absent, abstract or counterfactual because of their skills for engaging with what we will call “enlanguaged affordances”. We make use of the phenomenological analysis of speech in Merleau-Ponty to show how the multiple affordances an individual is ready to engage with in a particular situation will typically include enlanguaged affordances. (shrink)

The psychedelic psilocybin has shown promise both as treatment for psychiatric conditions and as a means of improving well-being in healthy individuals. In some jurisdictions (e.g., Oregon, USA), psilocybin use for both purposes is or will soon be allowed and yet, public attitudes toward this shift are understudied. We asked a nationally representative sample of 795 US Americans to evaluate the moral status of psilocybin use in an appropriately licensed setting for either treatment of a psychiatric condition or well-being enhancement. (...) Showing strong bipartisan support, participants rated the individual’s decision as morally positive in both contexts. These results can inform effective policy-making decisions around supervised psilocybin use, given robust public attitudes as elicited in the context of an innovative regulatory model. We did not explore attitudes to psilocybin use in unsupervised or non-licensed community or social settings. (shrink)

Blumenthal-Barby (2024) argues that bioethicists should stop using the concept of "personhood" in both well-established bioethics debates (e.g., regarding cognitive disability) and emerging ones (e...

The recent tragic and widely publicised death of Jesse Gelsinger in a gene therapy trial has many important lessons for those engaged in the ethical review of research. One of the most important lessons is that ethics committees can give too much weight to ensuring informed consent and not enough attention to minimising the harm associated with participation in research. The first responsibility of ethics committees should be to ensure that the expected harm associated with participation is reasonable. Jesse was (...) an 18-year-old man with a mild form of ornithine transcarbamylase (OTC) deficiency, a disorder of nitrogen metabolism. His form of the disease could be controlled by diet and drug treatment. On September 13 1999 a team of researchers lead by James Wilson at the University of Pennsylvania's Institute for Human Gene Therapy (IHGT) injected 3.8 X 1013 adenovirus vector particles containing a gene to correct the genetic defect. He was the eighteenth and final patient in the trial. The virus particles were injected directly into the liver. He received the largest number of virus particles in a gene therapy trial.1 Four days later he was dead from what was probably an immune reaction to the virus vector. This was the first death directly attributed to gene therapy. It resulted in worldwide publicity, an independent investigation, the Federal Drug Administration (FDA) suspending all trials at the IHGT, an FDA, and a senate subcommittee investigation. At a special public meeting at the National Institutes of Health (NIH) in December 1999, James Wilson, also the director of the IHGT, said they still did not understand fully what had gone wrong.2 Even though a massive dose had been used, only 1% of transferred genes reached the target cells. (None of the patients in the trial showed significant gene expression. Art …. (shrink)

Hughes offers a consequentialist response to our rejection of accommodation of conscientious objection in medicine. We argue here that his compromise proposition has been tried in many jurisdictions and has failed to deliver unimpeded access to care for eligible patients. The compromise position, entailing an accommodation of conscientious objection provided there is unimpeded access, fails to grasp that the objectors are both determined not to provide services they object to as well as to subvert patient access to the objected to (...) services. Unpredictable future developments in drug R&D and resulting treatment and prevention options in medicine make the compromise position unrealistic. (shrink)

A common strategy in bioethics is to posit a prima facie case in favour of one policy, and to then claim that the burden of proof falls on those with opposing views. If the burden of proof is not met, it is claimed, then the policy in question should be accepted. This article illustrates, and critically evaluates, examples of this strategy in debates about the sale of organs by living donors, human enhancement, and the precautionary principle. We highlight general problems (...) with this style of argument, and particular problems with its use in specific cases. We conclude that the burden ultimately falls on decision-makers to choose the policy supported by the best reasons. (shrink)

One objection to embryonic stem (ES) cell research is that it ‘cannibalizes’ human beings, that is, kills some human beings to benefit others. I grant for argument’s sake that the embryo is a person. Nonetheless, killing it may be justified. I show this through the Embryonic Stem Cell Lottery. Whether killing a person is justified depends on: (1) whether innocent people at risk of being killed for ES cell research also stand to benefit from the research and (2) whether their (...) overall chances of living are higher in a world in which killing and ES cell research is conducted. I call this kind of killing ‘risk reductive.‘. (shrink)

Over the past 10 years, John Harris has made important contributions to thinking about distributive justice in health care. In his latest work, Harris controversially argues that clinicians should stop prioritising patients according to prognosis. He argues that the good or benefit of health care is providing each individual with an opportunity to live the best and longest life possible for him or her. I call this thesis, opportunism. For the purpose of distribution of resources in health care, Harris rejects (...) welfarism (the thesis that the good of health care is well-being) and argues that utilitarianism in general may lead to de facto discrimination against groups of people needing health care. I argue that well-being is a superior theory of the good of health care to Harris' opportunism. Harris' concerns about utilitarianism can be better addressed by: (i) relating justice more closely to reasons for action; (ii) by conceptualising the relationship between reasons for action and the value of the consequences of those actions as a plateau rather than scalar relationship. Justice can be understood as satisfying as many equally rational claims on resources as possible. The rationality of a person's claim on health resources turns on the strength of that person's reasons to promote certain health-related states of affairs. I argue that the strength of that reason does not track the expected value of that state of affairs in a fully scalar fashion. Rather a person can have most reason to promote some state of affairs, even though he or she could promote other more valuable states of affairs. Thus there can be equal reason for a distributor of public resources to save either of two people, even though one will have a better and more valuable life. This approach, while addressing many of Harris' concerns about utilitarianism, does not imply that doctors should give up prioritising patients according to prognosis altogether, but it does allow that patients with lower but reasonable prognosis should have a share of public resources. (shrink)

Genomic sequencing technologies (GS) pose novel challenges not seen in older genetic technologies, making traditional standards for fully informed consent difficult or impossible to meet. This is due to factors including the complexity of the test and the broad range of results it may identify. Meaningful informed consent is even more challenging to secure in contexts involving significant time constraints and emotional distress, such as when rapid genomic testing (RGS) is performed in neonatal intensive care units. In this article, we (...) propose that informed consent matters not for its own sake, but because obtaining it furthers a range of morally important goals, such as promoting autonomy, well‐being, and trust in medicine. These goals form the basis of a new framework [PROmoting Morally Important Consent Ends (PROMICE)] for assessing the ethical appropriateness of various informed consent models. We illustrate this framework with two examples: (a) a tiered and layered consent model for obtaining consent for GS, and (b) consent for RGS in critically ill newborns. We conclude that appropriately—rather than fully—informed consent provides the correct standard for genomic medicine and research. (shrink)

Around a third of men worldwide are circumcised. It is probably the most commonly performed surgical procedure. Circumcision is also one of the oldest forms of attempted human enhancement. It is and has been done for religious, social, aesthetic and health reasons.Circumcision has a variety of benefits and risks, many of which are discussed in this issue. There is some dispute about the magnitude and likelihood of these benefits and risks. Some argue that the risks outweigh the benefits and circumcision (...) should not be performed on children who are not competent to make their own decisions.If the risks of circumcision clearly outweighed the benefits, great harm has been done and is being done globally through this procedure. Around a third of all men would have been harmed. This is an extraordinary public health injury. Presumably, many would be entitled to compensation.The fact that relatively few people think that the situation is as bad as this indicates that most people implicitly believe that circumcision is not generally a significant harm, if a harm at all. One might thus conclude either that: It is not clear from existing evidence whether the risks of properly performed circumcision outweigh the benefits, or vice versa.Or 2. If circumcision is against the interests of an infant or young child, it is only mildly so.In general, people should make their own decisions about body modification and human enhancement when this is possible. Such an approach speaks in favour of waiting until a child becomes an adult to make his or her own decision about circumcision. And procedures which are not clearly in a child's interests should not be performed on that child. However, religious …. (shrink)

We build on Ainslie's discussion of willpower by highlighting another common misconception in the literature: the conflation of self-control and willpower. In our commentary, we identify this issue and discuss the importance of recognizing willpower not as synonymous with self-control, but rather as a subset of self-control. We describe a set of upstream strategies as more effective alternatives to willpower.

According to recent empirical research (Transparency International, 2013), nearly 15% of people worldwide admitted to having paid a bribe in an educational setting. Given the nature of corruption,...

An innovative program recently initiated at the University of California, Los Angeles Medical Center allows people to donate a kidney in exchange for a voucher that a loved one can redeem for a kidney if and when needed. As a relatively new practice, the ethical implications of advanced kidney donation have not yet been widely discussed. This paper reflects on some of the bioethical issues at stake in this new donation program, as well as some broader philosophical issues related to (...) the meaning and moral salience of commodification. I first consider whether the literature on commercial markets in organs––a longstanding topic of bioethical debate––can meaningfully inform ethical analysis of kidney voucher programs. Specifically, I consider whether and to what extent common objections to the exchange of kidneys for cash also apply to the exchange of kidneys for “kidney vouchers.” Second, I argue that the contrast between the ethical issues raised by these two practices highlights the need to understand commodification as existing on a continuum, with different degrees of commodification giving rise to different ethical issues. Doing so can help sharpen our understanding of commodification as a moral concept, as well as its relevance to broader debates about the moral limits of markets. (shrink)

Greely’s target article outlines six categories of ethical issues associated with human brain surrogate research. Some of these issues are familiar from other research contexts; others, less...

Here, a moral case is presented as to why sign languages such as Auslan should be made compulsory in general school curricula. Firstly, there are significant benefits that accrue to individuals from learning sign language. Secondly, sign language education is a matter of justice; the normalisation of sign language education and use would particularly benefit marginalised groups, such as those living with a communication disability. Finally, the integration of sign languages into the curricula would enable the flourishing of Deaf culture (...) and go some way to resolving the tensions that have arisen from the promotion of oralist education facilitated by technologies such as cochlear implants. There are important reasons to further pursue policy proposals regarding the prioritisation of sign language in school curricula. (shrink)

Corruption in higher education has raised concern among governments, citizens, and the education community worldwide. However, few papers have sought to explore the students’ willingness to engage in corrupt practices at the university level. The present study aimed to examine the influence of different corrupt behaviours and perceived corruption among peers on the corrupt intention of university students. 120 undergraduate students participated in a quasi-experimental design divided in 3 treatments to rate their willingness to engage in favouritism and embezzlement behaviours. (...) Results pointed out that students were more prone to committing a non-monetary behaviour favouritism– than a monetary behaviour –embezzlement–. Furthermore, there were not significant differences between the groups of control and high-corruption acceptance; while only the group of low-corruption acceptance showed significant lower rates when compared to the control and the high-corruption acceptance’s group. Practical recommendations need to address students’ perceptions of different corrupt practices, focusing on designing ethical training programmes aimed to raise awareness on the negative consequences of non-monetary activities. Future research directions could generate empirical support to prove if students are able to recognize the underlying mechanisms of subtle corrupt practices. (shrink)

Advances in brain–brain interface technologies raise the possibility that two or more individuals could directly link their minds, sharing thoughts, emotions, and sensory experiences. This paper explores conceptual and ethical issues posed by such mind-merging technologies in the context of clinical neuroethics. Using hypothetical examples along a spectrum from loosely connected pairs to fully merged minds, the authors sketch out a range of factors relevant to identifying the degree of a merger. They then consider potential new harms like loss of (...) identity, psychological domination, loss of mental privacy, and challenges for notions of autonomy and patient benefit when applied to merged minds. While radical technologies may seem to necessitate new ethical paradigms, the authors suggest the individual-focus underpinning clinical ethics can largely accommodate varying degrees of mind mergers so long as individual patient interests remain identifiable. However, advanced decisionmaking and directives may have limitations in addressing the dilemmas posed. Overall, mind-merging possibilities amplify existing challenges around loss of identity, relating to others, autonomy, privacy, and the delineation of patient interests. This paper lays the groundwork for developing resources to address the novel issues raised, while suggesting the technologies reveal continuity with current healthcare ethics tensions. (shrink)

There is asbestos under the eaves of my house, outside my bedroom and bathroom. Imagine I want to remove it. I know there is a danger with asbestos removal causing asbestosis and mesothelioma. I do...

”Der ökonomische Markt ist nicht moralfrei“, sagt der angesehene Philosoph Julian Nida-Rümelin und präsentiert sein Modell einer humanen Ökonomie. Er glaubt an eine gut funktionierende Wirtschaftsordnung, die menschengerecht und nachhaltig ausgerichtet ist. Dabei sieht er darin keineswegs eine Utopie, sondern vielmehr eine praktikable Form, die unseren Alltag positiv verändern kann. Dieses Buch richtet sich an diejenigen, die über den Tag hinausdenken wollen, die über die Kritik an dem einen oder anderen gravierenden Fehlverhalten ökonomischer Akteure hinaus eine ethische Perspektive gewinnen (...) wollen, die sich Gedanken machen, wie eine auf Kooperation und moralischen Werten basierende Wirtschaftsordnung in der Weltgesellschaft aussehen könnte. (shrink)

The idea that humans are by nature social and political animals can be traced back to Aristotle. More recently, it has also generated great interest and controversy in related disciplines such as anthropology, biology, psychology, neuroscience and even economics. What is it about humans that enabled them to construct a social reality of unrivalled complexity? Is there something distinctive about the human mind that explains how social lives are organised around conventions, norms, and institutions? The Routledge Handbook of Philosophy of (...) the Social Mind is an outstanding reference source to the key topics and debates in this exciting subject and is the first collection of its kind. An international team of contributors present perspectives from diverse areas of research in philosophy, drawing on comparative and developmental psychology, evolutionary anthropology, cognitive neuroscience, and behavioural economics. The thirty-two original chapters are divided into five parts: _The Evolution of Social Mind_: including the social intelligence hypothesis, co- evolution of culture and cognition, ethnic cognition, cooperation; _Developmental and Comparative Perspectives_: including primate and infant understanding of mind, shared intentionality, and moral cognition; _Mechanisms of the Moral Mind:_ including norm compliance, social emotion, and implicit attitudes; _Naturalistic Approaches to Shared and Collective Intentionality_: including joint action, team reasoning and group thinking, and social kinds; _Social Forms of Selfhood and Mindedness_: including moral identity, empathy and shared emotion, normativity and intentionality. Essential reading for students and researchers in philosophy of mind and psychology, _The Routledge Handbook of Philosophy of the Social Mind _is also suitable for those in related disciplines such as social psychology, cognitive neuroscience, economics and sociology. (shrink)

ABSTRACTThis paper examines how decisions to limit treatment to critically ill patients under uncertainty can be made rationally. Expected utility theory offers one way of making rational decisions under uncertainty. One problem with using this approach is that we may not know the value of each option. One rational course open is to treat until further information becomes available. However, treatment can limit the range of options open. With treatment, a patient may recover such that he no longer requires life‐supporting (...) treatment. However, his life may be not worth living. If active euthanasia of %on‐terminal’conditions is prohibited, the option of dying will no longer be available. Taking a rational‘wait and see’course may result in being trapped within an unbearable life. On the other hand, sometimes present practice‘lets nature takes its course'. Critically ill patients are allowed to die because it is believed that their lives will be not worth living. It is likely that some patients are allowed to die when there is some objective chance of worthwhile future life. This paper argues that a policy of treating critically ill patients until the nature of future options can be better evaluated, in company with an offer of subsequent euthanasia where appropriate, allows a more rational and humane approach to treatment limitation decisions under uncertainty. (shrink)

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 advocacy approaches employed by healthcare providers and the correlated ethical challenges. We conducted a scoping review of qualitative literature by (...) systematically searching four databases—PubMed/Medline, Embase, Cinahl, and Cochrane Library. For developing our search strategy, we employed the PICO (Population, Intervention, Comparison, Outcome) scheme. Our analysis followed the qualitative content analysis approach proposed by Graneheim and Lundman. 30 studies were included, revealing a cumulative total of 915 healthcare providers who were interviewed. A total of 30 themes emerged comprising 14 advocacy approaches and 16 ethical challenges. Healthcare providers made a deliberate choice to engage in advocacy, responding to injustices experienced by undocumented migrants. The spectrum of advocacy initiatives varied, encompassing voluntary participation in healthcare provision, empathetic understanding, and healthcare-focused strategies. We also identified numerous correlated ethical challenges, necessitating healthcare providers to strike a balance between their eagerness to assist and their professional competence, respect the autonomy of undocumented migrants, and establish trust with them. These findings not only offer practical guidance for healthcare providers to enhance accessibility to healthcare services for undocumented migrant patients but also foster awareness of the ethical challenges that may arise in their advocacy roles. (shrink)