Epidemics have historically been both biomedical disasters and cultural stories that societies interpret and recount. This study explores the epidemic imaginary, examining how literature and cinema symbolically depict contagion by analysing narratives of contagion produced during the Plague era in literature and modern pandemic representations in film. The research considers some plague-era literature, such as Albert Camus' The Plague (1947) and Thomas Mann's Death in Venice (1912), alongside more recent pandemic literature like Dean Koontz's The Eyes of Darkness (1981), as well as two films: Contagion (2011), directed by Steven Soderbergh, and Outbreak (1995), directed by Wolfgang Petersen. Drawing from interdisciplinary fields including literary studies, film theory and medical humanities, the study highlights moments of systemic and existential responses to contagion. It explores recurring themes such as fear, denial, governance, death, mortality and resilience, demonstrating how epidemics serve as meaningful moments for both existential reflection and systemic analysis. I argue that epidemic stories function as cultural scripts, that literature subtly allegorises contagion through introspection, and that cinema vividly dramatises urgency by depicting collapsing systems. Overall, these works highlight how societies narrate and remember solidarity during crises, rearticulating collective resilience in the face of devastation.

Careful and intentional language use can improve healthcare outcomes for vulnerable populations. This essay critically analyses how metaphors shape clinical communication with childhood survivors of sexual abuse. Drawing on prior literature and insights from conversations with child abuse paediatricians and Trauma-Focused Cognitive Behavioural Therapy-certified psychologists, this essay discusses several key metaphors clinicians use when communicating with childhood survivors. Together, these perspectives inform our argument that metaphors-often treated as incidental in healthcare practice-are in fact fundamental to clinical interactions and are frequently employed without explicit awareness by practitioners. We also argue that helping clinicians become more aware of their implicit, often covert use of metaphors-and offering guidance on supportive versus harmful metaphorical framing-could be incorporated into medical education and trauma-informed care practices to better support patients who have experienced childhood sexual abuse. This essay also highlights the need for qualitative research that bridges medicine and linguistics to better understand how metaphors shape patient care experiences, particularly for this population.

Post-traumatic stress disorder (PTSD) represents a transcultural recurrent response to extreme events, documented across approximately four millennia of human history. Although formally codified in Diagnostic and Statistical Manual of Mental Disorders (DSM)-III (1980), descriptions of post-traumatic symptomatology already appear in Mesopotamian cuneiform texts (2027-2003 BCE) and continue through classical literature and modern clinical observation. This historical-critical analysis assesses the phenomenological continuity of trauma-related symptoms across epochs and cultures, reconstructing the evolution of aetiological interpretations from moral condemnation to medical and neurobiological recognition. Through a critical reading of historical, medical and literary sources, International Classification of Diseases (ICD)-11 and DSM-5-TR criteria are employed as heuristic descriptors to organise symptom language across periods, without implying retrospective diagnosis or strict nosographic equivalence. Core symptom domains display notable stability across military, civilian and childhood trauma contexts. Three paradigmatic shifts emerge: from moral to organic interpretations (1600-1900), from organic to psychodynamic understanding (1876-1920) and from military-specific recognition to a universal framework (1915-1980), with wars acting as accelerators of clinical conceptualisation and medicalisation. This research suggests that the divergence between the granularity of the DSM-5-TR and the parsimony of the ICD-11 is best interpreted as complementary operational strategies that, through a dialogical use of historical materials, can both inform and critically interrogate the contemporary nosology of PTSD. The contemporary challenge is to develop integrative models that honour both the universality of vulnerability and the uniqueness of each traumatic experience, while maintaining vigilance against restigmatisation. Overall, recognising trauma's historical continuity may inform current clinical practice and contribute to stigma reduction.

Unaccompanied refugee minors (URMs) represent one of the most vulnerable groups within the global refugee population, having fled armed conflict without familial support. Although policies in high-income countries secure URMs' basic rights-housing, education, healthcare and legal protection-these standardised frameworks frequently neglect the sociocultural and relational dimensions of identity integral to their well-being. To articulate the moral imperative of identity scaffolding in URM care, demonstrating how current approaches enforce assimilation, exacerbate identity distress and fail to promote long-term integration and mental health. This conceptual paper draws on interdisciplinary literatures-including policy analyses, identity theory, socioecological models and psychosocial research-to critique existing UK and EU interventions for URMs. It synthesises empirical findings on URMs' experiences of cultural dislocation, systemic inequities and resilience mechanisms, and integrates illustrative case examples from media and non-governmental organisation (NGO) reports. Three core themes were identified:Systemic inequities and assimilation pressures: Host-country policies often prioritise uniform legal compliance and assimilation metrics over cultural continuity, leading to social alienation and identity confusion.Identity distress as a key mediator: Psychological constructs of identity distress explain URMs' chronic anxiety, role uncertainty and emotional turmoil when forced to navigate conflicting cultural norms without adequate support.Relational identity scaffolding: Evidence indicates that pairing URMs with culturally matched foster carers or mentors-and embedding participatory, culturally attentive practices in schools, social services and healthcare-enhances resilience, fosters a stable sense of self and improves educational and mental health outcomes. A shift from 'tick-box' integration to an identity-centred framework is both ethically necessary and practically effective. Policymakers should implement identity impact assessments, invest in culturally informed mentorship and mental-health services, and engage URMs in codesigning support programmes. Such measures can mitigate identity distress, bolster civic inclusion and guide future research on the political dimensions of national identity curation.

Older adults are at risk of having their stories defined for them based on cultural expectations about the values and preferences of certain generations. In music therapy, these expectations can manifest in assumptions about how older adults relate to and engage with music. The resulting conflict between the authentic story and the assumed story is transgenerational narrative distortions where members of one generation disrupt, destabilise and deconstruct the lived experiences of another generation through a cultural projection of values, expectations and perspectives. Older adults stand to benefit from a process of narrative repair amplifying their authentic stories through a focus on whole persons defined by past, present and future experiences. Narratology provides a theoretical structure for shaping narrative repair processes through the theoretical constructs of 'historical epics' and 'novel': whereas historical epics frame the past as fixed and unmoving, novels understand characters to be in continuous evolution. Older adults in music therapy who are received as novels are subsequently empowered to continue forming identity through the full spectrum of their life. Clinical vignettes are provided to illustrate the harms of narrative distortions in music therapy, and how narrative repair can be reflexively integrated into culturally responsible assessment and clinical decision-making. Recommendations for clinicians include (A) Continued exploration of aspirational cultural humility, particularly as it relates to messaging about age and identity formation, (B) Development of reflexive assessments that navigate multiple areas of knowledge to determine health-optimising music experiences for older adults, and (C) Expansion of the repertories and intervention designs introduced in music therapy.

Artificial intelligence (AI) is transforming clinical practice while simultaneously raising concerns about trust. Drawing on complexity theory, this paper argues that the crisis of trust in medical AI is rooted in multiple forms of uncertainty, including non-causal statistical relations, system-level complexity and the irreducibility of clinical judgement. It introduces a 'U-map' (Uncertainty Map), a conceptual tool that links specific forms of uncertainty to role-appropriate clinical uses such as screening, triage or deliberation aid. Using this map, the paper calibrates model claims against distinct clinical epistemic roles and develops a multidimensional account of trust that spans technological reliability, institutional governance and cultural-emotional orientations. On this basis, the paper sketches a posthuman model of care in which human-machine collaboration and distributed accountability offer a more adequate response to the normative and epistemic challenges posed by medical AI.

Family members, relatives and friends are all affected when someone is hospitalised with a life-threatening illness. However, they often feel neglected and sometimes ignored by healthcare professionals. To address this, the reading of literature has been used in various clinical contexts in an attempt to humanise the care of patients and their relatives. Reading fiction enables healthcare professionals to imaginatively enter relatives' perspectives, fostering a deeper understanding of their experiences, which may in turn enhance family-centred care in clinical practice. However, research on how healthcare professionals engage with the reading of literary texts and what they discuss in such contexts has not yet been explored. This article presents findings from a qualitative study exploring a reading group for nurses at a hospital ward in Denmark, where literature on kinship was read and discussed. We examined the following specific research question: What takes place when nurses join a reading group in a clinical context to read and discuss literature on kinship?Based on a hermeneutical analysis of four audio-recorded reading group sessions, we identified the following three themes: (1) awareness of kinship and the negotiation of norms, (2) engagement with various perspectives and (3) acknowledgement of emotions when caring for family members. These themes are discussed in light of Felski's concept of recognition as knowing and acknowledgement. Additionally, by applying Meretoja's theory of narrative agency, we demonstrate how reading literature in a clinical setting can foster narrative agency, enabling nurses to expand and clarify their understandings and assumptions of kinship based on their ability to navigate and influence what Meretoja terms their 'narrative environment' in a clinical context.

This paper proposes an approach to designing equitable decentralised clinical trials (DCTs) to address ongoing structural disparities in clinical research. Continuing historical legacies of exploitation in clinical trials, such as unethical medical experimentation on vulnerable populations, combined with global power asymmetries, has resulted in global access gaps where over two billion people lack essential medicines and vaccines often developed through these very trials. Guidelines such as International Council for Harmonisation of Good Clinical Practice uphold ethical compliance for the protection of the rights, safety and well-being of human participants involved in clinical trials. Despite this critical role, these guidelines remain inadequate for confronting the deeper legacies of structural harm. DCTs offer a potential paradigm shift to expand participation by integrating digital health technologies and local networks. However, without deliberate attention to a justice-oriented design, they risk reproducing the same inequities they seek to overcome. We, therefore, draw on futures thinking and design justice to propose three interdependent strategies: (1) anticipatory justice, (2) institutionalising reciprocity and (3) relational accountability. Such an approach invites a shift in how innovation is imagined and enacted in clinical research, one that anticipates future challenges, foregrounds local voices and offers a pathway toward more just and equitable global healthcare systems. When grounded in equity and co-creation, DCTs could evolve from methodological innovation into a moral infrastructure: one that redistributes power, protects against duress and reimagines clinical research as a practice of solidarity and shared flourishing.

In this paper, I show how humiliation, as a moral emotion, is a pervasive yet neglected dimension of medicine, health and ethics discourse. Although often conflated with shame, humiliation names a distinct self-conscious emotion: not an internalised sense of personal failure, but a relational harm imposed by others and institutions that undermines dignity and self-respect. Recently, medical humanities and ethics literature has attended extensively to shame and stigma, yet humiliation remains underexplored, despite its salience in patient accounts of dismissal, disrespect and degradation. I begin by explaining why it helps to have a conceptual distinction between humiliation and shame, showing how humiliation is an externally inflicted injury rather than a private moral lapse. Drawing on my ethnographic and phenomenological research in India and Zurich, in this conceptual paper, I illustrate how humiliation surfaces in healthcare encounters and spaces, where patients, especially those who are marginalised, are silenced or disregarded. I show that humiliation is diagnostic and has inherent moral insights and reveals injustice. Thus, in this paper, I argue that reclaiming humiliation as a moral and phenomenological category opens new ethical and analytical possibilities: it calls for reimagining medicine as a relational practice grounded in dignity, recognition and justice-one that acknowledges those once humiliated not as passive sufferers but as moral agents whose emotions reveal the truth of injustice.