Harnessing Medical Bioethics Mediation to Advance One Health Governance

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.