This paper examines rights consciousness (RC) in hospitals during emergencies, drawing on interviews with bereaved relatives and healthcare workers from isolated COVID-19 wards in Israel. It reveals that neither group framed visitation as a formal legal entitlement but rather as a privilege, gift, or luxury. While visitation is a routine and expected practice in ordinary times, the crisis exposed its fragility, transforming it into a discretionary allowance whose availability depended on institutional priorities and frontline discretion. Family responses ranged from compliance to selective resistance, with rights awareness often emerging retrospectively and collectively. The analysis advances few theoretical insights. First, it conceptualizes visitation as a “fragile right” robust in everyday practice yet weakly anchored in law and easily erased in crisis. Second, it shows how “de facto rights” can re-emerge from within institutions through professional ethics, norms, and informal organizational diffusion. Third, it demonstrates that RC is relational and spatial, suppressed inside hospitals by clinical hierarchies, yet reconstructed outside them through collective comparison and shared experience. These dynamics suggest that strengthening such fragile rights may depend not only on legal reform but on bottom-up participation of patient/family in hospital policymaking during crisis, which can cultivate rights awareness from within care itself.

A cross-sectional study using point prevalence survey (PPS) methodology was conducted on May 20, 2024, at 18 tertiary care hospitals located in the 6 Gulf Cooperation Council (GCC) countries to assess the prevalence of healthcare-associated infections (HAIs) and associated pathogens. The measured outcome was the presence of active HAIs in different hospital units. During the PPS day, 651 HAI events were detected among 580 patients after reviewing the information of 6826 patients. The prevalence of patients with HAIs was 8.5% (95% CI 7.8%–9.2%). The prevalence was higher in older patients (11.8%, 95% CI 10.2%–13.4%), in intensive care units (24.6%, 95% CI 21.5%–27.8%), and in specialty care areas (12.7%, 95% CI 9.8%–15.7%). The most frequent type of HAIs was pneumonia (27.8%), followed by bloodstream infection (25.0%), urinary tract infection (10.9%), and skin infection (9.7%). Device-associated HAIs represented 15.4% of all HAIs, with ventilator-associated pneumonia, central line-associated bloodstream infection, and catheter-associated urinary tract infection being the main types. Approximately 61.9% of HAIs were microbiologically confirmed. Out of them, 65.3% were caused by Gram-negative bacteria and 31.8% were caused by multidrug-resistant pathogens. The findings confirm that the high HAI burden in GCC hospitals is higher in high-resource countries but lower in lower/middle-resource countries.

This paper examines the relationship between provider market consolidation, setting-of-care (SOC) dynamics, and healthcare costs in the United States. The authors argue that consolidation is not solely a driver of rising unit prices, but also a response to structural pressures, including rising practice costs, stagnant physician reimbursement, and increasing administrative complexity. Drawing on recent empirical analyses, the authors demonstrate that prices vary substantially by SOC, with hospital outpatient departments representing the highest-cost settings. They further show that physician affiliation models are associated with distinct patterns of SOC utilisation. These findings suggest that the relationship between consolidation and cost is not uniform and depends on underlying organisational incentives. The authors contend that current policy discourse around private capital lacks sufficient nuance and risks obscuring more fundamental drivers of cost growth, particularly reimbursement design. They call for a more balanced dialogue and additional research to better understand how consolidation, payment policy, and SOC decision-making interact, concluding that policymakers should prioritise incentives that support clinically appropriate care in lower-cost settings.

Since their publication in the 1950s and 1980s respectively, the Commentaries on the Geneva Conventions of 1949 and their Additional Protocols of 1977 have become a major reference for the application and interpretation of those treaties. The International Committee of the Red Cross, together with a team of renowned experts, is currently updating these Commentaries in order to document developments and provide up-to-date interpretations of the treaty texts. This article provides an introduction to the updated Commentary on Geneva Convention IV (GC IV), published online in 2025. It describes the methodology behind the updated Commentaries before explaining the historical background of bringing civilian protection into the framework of the Geneva Conventions. It then discusses how the structure of GC IV impacts its application and explains GC IV’s personal, geographic and temporal scope of application. The article summarizes key substantive protections provided in the Convention for civilians and their property during armed conflicts, including in situations of occupation, and points to where these are addressed in the updated Commentary.

Nicolas Gérard is a Senior Political Affairs Officer at the United Nations (UN) with over twenty years of experience in international security and human rights. As the Chief of the Monitoring, Reporting and Regional Partnerships Unit, he currently plays a leading role in the Office of the Special Representative of the Secretary-General for Children and Armed Conflict, where he heads the monitoring of grave violations against children in armed conflict. Previously, he held key positions at UN Headquarters and in the field, including a posting in Togo and tenures with the UN Office for Disarmament Affairs and the UN Institute for Disarmament Research.

Volunteers are recognized as people devoting significant time to provide unpaid services to social organizations. In nonprofit hospitals, volunteers play three essential roles. First, they provide assistance and care to patients. Secondly, they generate strategic value through fundraising, marketing, and community relations’ activities. Third, they generate financial benefits for the institution by reducing hospital costs. This article examines such roles and contributions of volunteers at two Brazilian nonprofit hospitals. Managers at these organizations consider volunteers valuable for the psycho-social service they provide, the strategic actions they develop, the cost savings they generate, the goodwill they create, and the funds they raise. In conclusion, volunteers at both hospitals are key stakeholders whose altruistic motives as good citizens motivate them to join either of the organizations, help humanize their services, and assist with the development of strategies that make significant contributions to the improvement of performance at both locales.

Research concerning executive compensation has a long history. However, most studies have been conducted on publicly traded investor-owned enterprises. Although the not-for-profit sector experienced explosive growth during the 1990s, little work has been devoted to understanding its executive compensation schemes and incentives arrangements. In the United States, recent Federal and State legislation has changed the landscape under which nonprofits must operate to avoid penalties for paying excessive compensation to its executives. Studies of compensation schemes under different organizational arrangements are limited. This paper uses the U.S. hospital industry to link the for-profit and nonprofit compensation and incentive literatures. It highlights selected for-profit executive compensation and incentive processes and suggests how some of these methods could be applied in a nonprofit setting.

Medicaid has been called the “workhorse” of the American health care system, but one would hardly see that in the tenor of political debates. The Program perennially faces political headwinds that at times build to hurricane force with proposals for dramatic structural changes and spending cuts, most recently the draconian cuts enacted by Congress in 2025. In 2024, Medicaid covered more than seventy million Americans, and another ten million were covered by its companion program, the Children’s Health Insurance Program. As formidable as these numbers are, the Program’s impact runs much deeper, affecting the lives of almost everyone in the United States. It serves as an essential support for the entire health care system and, in doing so, helps to sustain almost every hospital, nursing home, and a range of other providers. This support, in turn, generates population-wide benefits that can be seen as public goods on which everyone relies, whether they realize it or not, that the private sector could not provide. These include peace of mind from knowing there is access to inpatient hospital care, emergency rooms, and long-term care when needed, protection from public health threats, improved health care based on continual innovation, greater social stability, enhanced economic productivity, and reduced health inequities. As devastating as proposals to shrink Medicaid would be for millions of low-income Americans who rely on it for access to health care, these repercussions would cause hardship for almost everyone.

This article explains Medicaid’s role in sustaining the overall health care system, the nature of the public goods it produces in doing so, and the widespread harm that would be caused were these public goods to be diminished. By characterizing public debates in this way, the Program’s supporters could reframe political discourse as a matter of universal self-interest.

The extent to which EU competition law applies in the healthcare context remains a contested question. The contemporaneous publication of the European Commission’s Evaluation of State Subsidy rules for health and social services of general economic interest (SGEI) in December 2022, and of the Court of Justice of the European Union’s April 2023 judgment in Casa Regina Apostolorum regarding state support to hospitals in Italy, underscore uncertainty and appear to indicate an impasse. These publications unfold against the backdrop of two tensions: between state and market, and between the EU and national levels. Hospitals illustrate these tensions well due to the expansion of competition mechanisms into the hospital sector (notably expanding private provider delivery of public hospital services, often supported by “patient choice” policies), and of hospitals remaining typically local or regional in character rather than supranational. This article provides a timely and original analysis of the Casa Regina Apostolorum judgment in light of Commission policy regarding SGEI and hospitals and how EU Member States engage with this. It offers insights into the potential legacy of Casa Regina Apostolorum, and indicates where future legal challenges may focus.

In the annual presidential address to the American Society of Church History (ASCH), Esther Chung-Kim discusses the pivotal role of pastors, physicians, and lay healers in responding to poverty and illness in early modern Europe. She offers that their involvement shaped both social welfare and medical care. Reflecting the values of biblical examples, both Catholics and Protestants established institutions to support the sick and poor. Promoting practices of care for the sick, religious leaders, pious physicians, and lay healers promoted charity through medicine, in various efforts to expand access to care. Protestant reformers sought to shift responses to illness away from saintly intercession and instead toward direct appeals to God and natural medicine, seen as a divine gift. In some cities, Reformed ordinances mandated medical support for the poor by institutionalizing care during epidemics. The convergence of religious and medical reform, aided by print culture, resulted in Christian thinkers recognizing medicine as a form of God’s providence in nature (thereby encouraging a positive view of medicine), and physicians promoting religious reform in their medical treatises. In the early modern era, Catholics and Protestants both strengthened the link between Christianity and medicine with theological and practical ways to show care and concern for the sick.