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Kickbusch’s call to reframe artificial intelligence (AI) governance through a planetary health lens is timely and compelling.1 As AI systems—particularly large language model (LLM) applications—move rapidly into use, we must ask how governance can be operationalised in healthcare practice.One of the most practical and underused levers for responsible AI is robust evaluation. In healthcare, evaluation standards have long aligned innovation with patient safety, quality, and equity. Encouragingly, this is a growing area of AI research, with emerging frameworks for assessing clinical performance,23 extensions to trial reporting such as CONSORT-AI,4 and examples of structured safety testing in real world tools.5A critical gap remains, however. Current evaluation frameworks rarely consider the computational and environmental costs of LLM powered systems, with environmental impact absent from criteria even in otherwise comprehensive approaches.6 Although recent frameworks such as FUTURE-AI7 have broadened evaluation, environmental and computational impact remain largely neglected. Each LLM query carries an energy...

Six months after the Gaza ceasefire was announced Palestinians are still experiencing “extreme deprivation, hunger, injury, and death” as Israeli attacks and aid restrictions continue, charities have warned.1Five major humanitarian organisations—the Danish Refugee Council, the Norwegian Refugee Council, Oxfam, Refugees International, and Save the Children—have assessed the progress made against the ceasefire plan and produced a scorecard. They conclude that the ceasefire announced in October 2025, with the promise of an end to attacks and an increase in aid, is failing.At least 738 Palestinians have been killed since the ceasefire came into effect, said the UN.2 At least 70 000 Gazans have been killed in Israeli attacks since 7 October 2023, although experts say that the true number is probably much higher.3The UN’s human rights chief, Volker Türk, said that Palestinians were still unsafe amid routine Israeli attacks. “The unrelenting pattern of killings reflects continuing disregard for Palestinian lives, enabled...

I have multiple sclerosis, and am under the care of several different healthcare teams. In follow-up appointments I am often asked whether anything has changed since I was last seen, whether there have been new symptoms or relapses, and whether there is anything different to report. On paper, the answer is frequently no. My scans are described as stable and there has been no dramatic event that alters management. From the outside, I appear much the same as before. Yet my body does not feel the same to me, and that difference rarely finds its way into the consultation.I use a wheelchair full time, and because of this many of the changes I experience are not visible. They do not present as new milestones or obvious shifts in function. Instead, they are internal and incremental. Movements require more effort than they used to, stamina shortens, and muscles fatigue more quickly,...

Media can be hugely powerful in changing our attitudes to health and ways of living. Channel 4’s recent docudrama Dirty Business highlighted the shocking scale of pollution of England’s rivers and seas.12 It showed devastating health harms linked to releases of untreated sewage, along with statistics and personal stories. The final episode listed some startling facts. In 2024, water companies in England made nearly a million illegal sewage dumps. Surfers Against Sewage reported that around 1500 people contacted it about illness caused by swimming in sewage contaminated water in 2023.The dramatised stories in Dirty Business, of damage to the health and lives of people playing or working in the water, are potent. These include E coli 0157 causing multiple agonising infections and the death of a child after playing in the sea; Streptococcus bacteria causing heart valve infection requiring a heart transplant; hepatitis A causing liver dysfunction; and other pathogens...

At the end of 2025 Clare McNaught took office as president of the Royal College of Surgeons of Edinburgh—the first woman to hold this position in the organisation’s 520 year history.“I was very aware that our college never had a female president, and that’s not right,” says McNaught, a Yorkshire based consultant general surgeon. “If you look at the medical workforce, 60% of medical students are now women. Surgery always has lagged behind in attracting women to the profession, which I think is a real shame because it’s an absolutely fantastic career.”McNaught tells The BMJ she knew that a female president “had to happen at some point,” and she’s glad that she had the opportunity to “get over that glass ceiling.”It’s been a long road to get to this point, however. McNaught has been involved in the college for 14 years, working her way from council member to journal editor...

Update and outcome to the journal’s expression of concern, March 2026: The journal has concluded its investigation into the concerns raised in the expression of concern below. The article by Attar and colleagues (BMJ 2025;391:e083382, doi:10.1136/bmj-2024-083382, published 29 October 2025) has been corrected1 to remove two individuals from the author list as they did not meet the authorship criteria. The article has also been retracted2 due to concerns about the reliability of the trial and the integrity of the reported data, which have been referred to the Iran Food and Drug Administration for independent review.Original expression of concern (12 November 2025)What happened after publicationIn this paper by Attar and colleagues (BMJ 2025;391:e083382, doi:10.1136/bmj-2024-083382, published 29 October 2025), The BMJ was alerted to post-publication discussion raising concerns about a variety of issues; some issues were apparent from the data that support the paper, and are linked to from the article. Examples...