# Harnessing Medical Bioethics Mediation to Advance One Health Governance

## TL;DR

This paper suggests using medical-bioethics mediation to improve cooperation and trust in One Health governance, which deals with health threats involving humans, animals, and the environment.

## Contribution

The paper introduces medical-bioethics mediation as a novel approach to address conflicts and enhance collaboration in multisectoral One Health governance.

## Key findings

- Medical-bioethics mediation can foster trust and cooperation across sectors in One Health contexts.
- The framework applies mediation principles like neutrality and respect to multisectoral health challenges.
- Examples from zoonotic disease control and environmental health demonstrate mediation's potential in ethical deliberation.

## Abstract

Health threats such as infectious diseases, antibiotic resistance, and environmental changes involve people, animals, and nature together. Because they cross many areas of society, they often lead to disagreements between farmers, veterinarians, public health officials, environmental groups, and local communities. Such disagreements can slow down disease control, weaken cooperation, and reduce trust. This article explores how medical-bioethics mediation, a method used in hospitals to help doctors and families resolve conflicts, can also help different groups work together in broader health and environmental decisions. Mediation offers a respectful and neutral space where people can express concerns, understand each other’s viewpoints, and find solutions that everyone can support. Application of these skills to national planning, disease response, and environmental management, societies may reduce conflict, improve communication, and build trust across sectors. This approach can help create fairer, more effective, and more sustainable decisions that benefit both communities and the natural world.

One Health envisions integrated governance across human, animal, and environmental systems to prevent and respond to complex health threats. Despite its global endorsement, One Health implementation often falters due to institutional fragmentation, power asymmetries, and ethical tensions that erode trust and cooperation. This paper proposes the integration of medical-bioethics mediation within One Health governance as a structured, relational mechanism to manage conflict, foster ethical deliberation, and strengthen trust between sectors and communities. We develop a conceptual framework to apply the mediation principles of neutrality, confidentiality, respect, and shared problem-solving beyond clinical ethics toward multisectoral One Health contexts. The framework is illustrated through domain-specific examples from zoonotic disease control, antimicrobial resistance, and environmental health. Medical bioethics mediation can advance conflict transformation, ethical reflection, participatory decision-making, and policy alignment, thereby supporting transparent negotiation of values and institutionalized dialogue of different One Health actors. Future research should pilot mediation-based governance models and assess their effects on intersectoral trust, collaborative capacity, and integrated health outcomes.