683 results match your criteria BMC Medical Ethics [Journal]


Conscientious objection to abortion, the law and its implementation in Victoria, Australia: perspectives of abortion service providers.

BMC Med Ethics 2019 Jan 31;20(1):11. Epub 2019 Jan 31.

Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, 3010, Australia.

Background: In Victoria, Australia, the law regulating abortion was reformed in 2008, and a clause ('Section 8') was introduced requiring doctors with a conscientious objection to abortion to refer women to another provider. This study reports the views of abortion experts on the operation of Section 8 of the Abortion Law Reform Act in Victoria.

Methods: Nineteen semi-structured qualitative interviews were conducted with purposively selected Victorian abortion experts in 2015. Read More

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http://dx.doi.org/10.1186/s12910-019-0346-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6354355PMC
January 2019

The picture talk project: Aboriginal community input on consent for research.

BMC Med Ethics 2019 Jan 29;20(1):12. Epub 2019 Jan 29.

Discipline of Child and Adolescent Health, Sydney Medical School, the Chidren's Hospital at Westmead, University of Sydney, Sydney, NSW, Australia.

Background: The consent and community engagement process for research with Indigenous communities is rarely evaluated. Research protocols are not always collaborative, inclusive or culturally respectful. If participants do not trust or understand the research, selection bias may occur in recruitment, affecting study results potentially denying participants the opportunity to provide more knowledge and greater understanding about their community. Read More

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https://bmcmedethics.biomedcentral.com/articles/10.1186/s129
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http://dx.doi.org/10.1186/s12910-019-0349-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352438PMC
January 2019
1 Read

A framework for the ethical assessment of chimeric animal research involving human neural tissue.

BMC Med Ethics 2019 Jan 25;20(1):10. Epub 2019 Jan 25.

Department of Medicine, Lund University, Sölvegatan 19, 22100, Lund, Sweden.

Background: Animal models of human diseases are often used in biomedical research in place of human subjects. However, results obtained by animal models may fail to hold true for humans. One way of addressing this problem is to make animal models more similar to humans by placing human tissue into animal models, rendering them chimeric. Read More

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http://dx.doi.org/10.1186/s12910-019-0345-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6347750PMC
January 2019
4 Reads

Research approvals iceberg: how a 'low-key' study in England needed 89 professionals to approve it and how we can do better.

BMC Med Ethics 2019 Jan 25;20(1). Epub 2019 Jan 25.

Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Institute of Public Health, Forvie Site, Robinson Way, Cambridge, CB2 0SR, UK.

Background: The red tape and delays around research ethics and governance approvals frequently frustrate researchers yet, as the lesser of two evils, are largely accepted as unavoidable. Here we quantify aspects of the research ethics and governance approvals for one interview- and questionnaire-based study conducted in England which used the National Health Service (NHS) procedures and the electronic Integrated Research Application System (IRAS). We demonstrate the enormous impact of existing approvals processes on costs of studies, including opportunity costs to focus on the substantive research, and suggest directions for radical system change. Read More

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http://dx.doi.org/10.1186/s12910-018-0339-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6346542PMC
January 2019

The psychology of "cure" - unique challenges to consent processes in HIV cure research in South Africa.

BMC Med Ethics 2019 Jan 24;20(1). Epub 2019 Jan 24.

HIV AIDS STDs and TB, Human Sciences Research Council, Cape Town, South Africa.

Background: Consent processes for clinical trials involving HIV prevention research have generated considerable debate globally over the past three decades. HIV cure/eradication research is scientifically more complex and consequently, consent processes for clinical trials in this field are likely to pose a significant challenge. Given that research efforts are now moving toward HIV eradication, stakeholder engagement to inform appropriate ethics oversight of such research is timely. Read More

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http://dx.doi.org/10.1186/s12910-019-0348-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6346569PMC
January 2019

How to effectively obtain informed consent in trauma patients: a systematic review.

BMC Med Ethics 2019 Jan 23;20(1). Epub 2019 Jan 23.

Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.

Background: Obtaining adequate informed consent from trauma patients is challenging and time-consuming. Healthcare providers must communicate complicated medical information to enable patients to make informed decisions. This study aimed to explore the challenges of obtaining valid consent and methods of improving the quality of the informed consent process for surgical procedures in trauma patients. Read More

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http://dx.doi.org/10.1186/s12910-019-0347-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6343333PMC
January 2019

Illness and disease: an empirical-ethical viewpoint.

BMC Med Ethics 2019 Jan 9;20(1). Epub 2019 Jan 9.

Institute of Ethics and History of Medicine, University Medicine Greifswald, Ellernholzstr. 1-2, 17487, Greifswald, Germany.

Background: The concepts of disease, illness and sickness capture fundamentally different aspects of phenomena related to human ailments and healthcare. The philosophy and theory of medicine are making manifold efforts to capture the essence and normative implications of these concepts. In parallel, socio-empirical studies on patients' understanding of their situation have yielded a comprehensive body of knowledge regarding subjective perspectives on health-related statuses. Read More

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http://dx.doi.org/10.1186/s12910-018-0341-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6327539PMC
January 2019
1 Read

Circumcision registry promotes precise research and fosters informed parental decisions.

BMC Med Ethics 2019 Jan 9;20(1). Epub 2019 Jan 9.

Attorneys for the Rights of the Child, Berkeley, CA, USA.

Background: In 2017 Ploug and Holm argued that anonymizing individuals in the Danish circumcision registry was insufficient to protect these individuals from what they regard as the potential harms of being in the registry (overreaching social pressure, stigmatization, medicalization of a religious practice, discrimination and promoting polarized research).

Discussion: We argue that Ploug and Holm's fears in each of the areas are misguided, not supported by the evidence, and could interfere with the gathering of accurate data. The extent of the risks and harms associated with ritual circumcision is not well known. Read More

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http://dx.doi.org/10.1186/s12910-018-0337-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6327488PMC
January 2019
2 Reads

Kenyan health stakeholder views on individual consent, general notification and governance processes for the re-use of hospital inpatient data to support learning on healthcare systems.

BMC Med Ethics 2019 Jan 8;20(1). Epub 2019 Jan 8.

KEMRI Wellcome Trust Research Programme, Kilifi, 80108, Kenya.

Background: Increasing adoption of electronic health records in hospitals provides new opportunities for patient data to support public health advances. Such learning healthcare models have generated ethical debate in high-income countries, including on the role of patient and public consent and engagement. Increasing use of electronic health records in low-middle income countries offers important potential to fast-track healthcare improvements in these settings, where a disproportionate burden of global morbidity occurs. Read More

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http://dx.doi.org/10.1186/s12910-018-0343-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6325859PMC
January 2019
2 Reads

Participants' awareness of ethical compliance, safety and protection during participation in pharmaceutical industry clinical trials: a controlled survey.

BMC Med Ethics 2019 Jan 8;20(1). Epub 2019 Jan 8.

Endocrinology Division, Department of Internal Medicine, "Dr. José E. González" University Hospital, Universidad Autonoma de Nuevo Leon, 64460, Monterrey, Mexico.

Background: The rapid increase of industry-sponsored clinical research towards developing countries has led to potentially complex ethical issues to assess. There is scarce evidence about the perception of these participants about the ethical compliance, security, and protection. We sought to evaluate and contrast the awareness and perception of participants and non-participants of industry-sponsored research trials (ISRT) on ethical, safety, and protection topics. Read More

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http://dx.doi.org/10.1186/s12910-018-0344-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6323663PMC
January 2019
3 Reads
1.600 Impact Factor

Shall parent / patient wishes be fulfilled in any case? A series of 32 ethics consultations: from reproductive medicine to neonatology.

BMC Med Ethics 2019 Jan 8;20(1). Epub 2019 Jan 8.

Department of Clinical Ethics, Psychiatric Hospitals of the University Basel, University Hospital, University of Basel, Wilhelm Klein-Strasse 27, CH-4002, Basel, Switzerland.

Background: Questions concerning the parent/ patient's autonomy are seen as one of the most important reasons for requesting Ethics Consultations (ECs). Respecting parent/ patient's autonomy also means respecting the patient's wishes. But those wishes may be controversial and sometimes even go beyond legal requirements. Read More

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http://dx.doi.org/10.1186/s12910-018-0342-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6325683PMC
January 2019
2 Reads

Does written informed consent adequately inform surgical patients? A cross sectional study.

BMC Med Ethics 2019 Jan 7;20(1). Epub 2019 Jan 7.

Department of Experimental Medicine, Campania University L. Vanvitelli, Section of Hygiene Via L. Armanni 5, 80138, Naples, Italy.

Background: Informed consent (IC) is an essential step in helping patients be aware of consequences of their treatment decisions. With surgery, it is vitally important for patients to understand the risks and benefits of the procedure and decide accordingly. We explored whether a written IC form was provided to patients; whether they read and signed it; whether they communicated orally with the physician; whether these communications influenced patient decisions. Read More

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http://dx.doi.org/10.1186/s12910-018-0340-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6323683PMC
January 2019
1 Read

African bioethics: methodological doubts and insights.

Authors:
John Barugahare

BMC Med Ethics 2018 12 27;19(1):98. Epub 2018 Dec 27.

Department of Philosophy, Makerere University, P. O. Box 7062, Kampala, Uganda.

Background: A trend called 'African bioethics' is growing on the continent due to perceptions of existing bioethics, especially guidelines for international collaborative research, as 'ethical imperialism'. As a potential alternative to 'Western Principlism,' 'African bioethics' is supposed to be indigenous to Africa and reflective of African identity. However, despite many positive insights in the on-going discussions, it is feared that the growth of bioethics in Africa lacks a clear direction. Read More

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http://dx.doi.org/10.1186/s12910-018-0338-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6307138PMC
December 2018
1 Read

Developing an ethics support tool for dealing with dilemmas around client autonomy based on moral case deliberations.

BMC Med Ethics 2018 12 22;19(1):97. Epub 2018 Dec 22.

Department of Medical Humanities, VU University Medical Centre, APH, Amsterdam, The Netherlands.

Background: Moral Case Deliberations (MCDs) are reflective dialogues with a group of participants on their own moral dilemmas. Although MCD is successful as clinical ethics support (CES), it also has limitations. 1. Read More

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http://dx.doi.org/10.1186/s12910-018-0335-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6303905PMC
December 2018
1 Read

Participation in a single-blinded pediatric therapeutic strategy study for juvenile idiopathic arthritis: are parents and patient-participants in equipoise?

BMC Med Ethics 2018 12 20;19(1):96. Epub 2018 Dec 20.

Department of Medical Ethics and Health Law, Leiden University Medical Center, Leiden, the Netherlands.

Background: Genuine uncertainty on superiority of one intervention over the other is called equipoise. Physician-investigators in randomized controlled trials (RCT) need equipoise at least in studies with more than minimal risks. Ideally, this equipoise is also present in patient-participants. Read More

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http://dx.doi.org/10.1186/s12910-018-0336-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6302476PMC
December 2018
2 Reads

Experiences of pre-hospital emergency medical personnel in ethical decision-making: a qualitative study.

BMC Med Ethics 2018 12 19;19(1):95. Epub 2018 Dec 19.

Department of Psychiatric Nursing, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Emergency care providers regularly deal with ethical dilemmas that must be addressed. In comparison with in-hospital nurses, emergency medical service (EMS) personnel are faced with more problems such as distance to resources including personnel, medico-technical aids, and information; the unpredictable atmosphere at the scene; arriving at the crime scene and providing emergency care for accident victims and patients at home. As a result of stressfulness, unpredictability, and often the life threatening nature of tasks that ambulance professionals have to deal with every day, ethical decision-making (EDM) has become an inevitable challenge. Read More

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http://dx.doi.org/10.1186/s12910-018-0334-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6299934PMC
December 2018
1 Read

Exploring the ethics of global health research priority-setting.

BMC Med Ethics 2018 12 6;19(1):94. Epub 2018 Dec 6.

Milken Institute School of Public Health, George Washington University, Washington, USA.

Background: Thus far, little work in bioethics has specifically focused on global health research priority-setting. Yet features of global health research priority-setting raise ethical considerations and concerns related to health justice. For example, such processes are often exclusively disease-driven, meaning they rely heavily on burden of disease considerations. Read More

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http://dx.doi.org/10.1186/s12910-018-0333-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6282311PMC
December 2018
1 Read

Consent requirements for research with human tissue: Swiss ethics committee members disagree.

BMC Med Ethics 2018 11 26;19(1):93. Epub 2018 Nov 26.

Institute for Biomedical Ethics, Bernoullistrasse 28, 4055, Basel, Switzerland.

Background: In Switzerland, research with identifiable human tissue samples, and/or its accompanying data, must be approved by a research ethics committee (REC) before it can be allowed to take place. However, as the demand for such tissue has rapidly increased in recent years, and biobanks have been created to meet these needs, committees have had to deal with a growing number of such demands. Detailed instructions for evaluating every kind of tissue request are scarce. Read More

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http://dx.doi.org/10.1186/s12910-018-0331-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6260886PMC
November 2018
1 Read

A qualitative study on the voluntariness of counselling and testing for HIV amongst antenatal clinic attendees: do women have a choice?

BMC Med Ethics 2018 11 21;19(1):92. Epub 2018 Nov 21.

Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es salaam, Tanzania.

Background: Mother-to-child transmission (MTCT) of the Human Immunodeficiency -Virus (HIV) is a serious public health problem, contributing up to 90% of childhood HIV infections. In Tanzania, the prevention-of-mother-to-child-transmission (PMTCT) feature of the HIV programme was rolled out in 2000. The components of PMTCT include counselling and HIV testing directed at antenatal clinic attendees. Read More

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http://dx.doi.org/10.1186/s12910-018-0329-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6249978PMC
November 2018
7 Reads

Parents' attitudes towards and perceptions of involving minors in medical research from the Japanese perspective.

BMC Med Ethics 2018 11 21;19(1):91. Epub 2018 Nov 21.

School of Political Science and Economics, Waseda University, 1-6-1 Nishi Waseda Shinjyuku-ku, Tokyo, 169-8050, Japan.

Background: Children's intentions should be respected. Parents are the key persons involved in decision-making related to their children. In Japan, the appropriate ages and standards for a child's consent and assent, approval, and decision-making are not clearly defined, which makes the process of obtaining consent and assent for clinical research complex. Read More

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http://dx.doi.org/10.1186/s12910-018-0330-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6249915PMC
November 2018
1 Read

Stakeholder views regarding ethical issues in the design and conduct of pragmatic trials: study protocol.

BMC Med Ethics 2018 11 20;19(1):90. Epub 2018 Nov 20.

Clinical Epidemiology Program, Ottawa Hospital Research Institute, Civic Campus, 1053 Carling Avenue, Civic Box 693, Admin Services Building, ASB 2-013, Ottawa, ON, K1Y 4E9, Canada.

Background: Randomized controlled trial (RCT) trial designs exist on an explanatory-pragmatic spectrum, depending on the degree to which a study aims to address a question of efficacy or effectiveness. As conceptualized by Schwartz and Lellouch in 1967, an explanatory approach to trial design emphasizes hypothesis testing about the mechanisms of action of treatments under ideal conditions (efficacy), whereas a pragmatic approach emphasizes testing effectiveness of two or more available treatments in real-world conditions. Interest in, and the number of, pragmatic trials has grown substantially in recent years, with increased recognition by funders and stakeholders worldwide of the need for credible evidence to inform clinical decision-making. Read More

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http://dx.doi.org/10.1186/s12910-018-0332-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6247737PMC
November 2018
9 Reads
1.600 Impact Factor

Defining and categorizing outcomes of Moral Case Deliberation (MCD): concept mapping with experienced MCD participants.

BMC Med Ethics 2018 11 19;19(1):88. Epub 2018 Nov 19.

Department of Epidemiology & Biostatistics, Amsterdam University Medical Centers location VUmc, Amsterdam, the Netherlands.

Background: To support healthcare professionals in dealing with ethically difficult situations, Clinical Ethics Support (CES) services like Moral Case Deliberation (MCD) are increasingly implemented. To assess the impact of CES, it is important to evaluate outcomes. Despite general claims about outcomes from MCD experts and some qualitative research, there exists no conceptual analysis of outcomes yet. Read More

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http://dx.doi.org/10.1186/s12910-018-0324-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6245560PMC
November 2018
2 Reads

A comprehensive systematic review of stakeholder attitudes to alternatives to prospective informed consent in paediatric acute care research.

BMC Med Ethics 2018 11 20;19(1):89. Epub 2018 Nov 20.

Emergency Medicine Research, Children's Emergency Department, Starship Children's Hospital, Auckland District Health Board, Private Bag 92024, Auckland, 1142, New Zealand.

Background: A challenge of performing research in the paediatric emergency and acute care setting is obtaining valid prospective informed consent from parents. The ethical issues are complex, and it is important to consider the perspective of participants, health care workers and researchers on research without prospective informed consent while planning this type of research.

Methods: We performed a systematic review according to PRISMA guidelines, of empirical evidence relating to the process, experiences and acceptability of alternatives to prospective informed consent, in the paediatric emergency or acute care setting. Read More

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http://dx.doi.org/10.1186/s12910-018-0327-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6245534PMC
November 2018
1 Read
1.600 Impact Factor

Application of the rapid ethical assessment approach to enhance the ethical conduct of longitudinal population based female cancer research in an urban setting in Ethiopia.

BMC Med Ethics 2018 11 14;19(1):87. Epub 2018 Nov 14.

School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.

Background: Rapid Ethical Assessment (REA) is an approach used to design context tailored consent process for voluntary participation of participants in research including human subjects. There is, however, limited evidence on the design of ethical assessment in studies targeting cancer patients in Ethiopia. REA was conducted to explore factors that influence the informed consent process among female cancer patients recruited for longitudinal research from Addis Ababa Population-based Cancer Registry. Read More

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https://bmcmedethics.biomedcentral.com/articles/10.1186/s129
Publisher Site
http://dx.doi.org/10.1186/s12910-018-0328-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6237025PMC
November 2018
11 Reads
1.600 Impact Factor

Challenges arising when seeking broad consent for health research data sharing: a qualitative study of perspectives in Thailand.

BMC Med Ethics 2018 11 7;19(1):86. Epub 2018 Nov 7.

The Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.

Background: Research funders, regulatory agencies, and journals are increasingly expecting that individual-level data from health research will be shared. Broad consent to such sharing is considered appropriate, feasible and acceptable in low- and middle-income settings, but to date limited empirical research has been conducted to inform the design of such processes. We examined stakeholder perspectives about how best to seek broad consent to sharing data from the Mahidol Oxford Tropical Medicine Research Unit, which implemented a data sharing policy and broad consent to data sharing in January 2016. Read More

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http://dx.doi.org/10.1186/s12910-018-0326-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6223036PMC
November 2018
4 Reads

Impact of moral case deliberation in healthcare settings: a literature review.

BMC Med Ethics 2018 11 6;19(1):85. Epub 2018 Nov 6.

Radboud university medical center, Radboud Institute for Health Sciences, IQ healthcare, Geert Grooteplein 21, P.O. Box 9101 (114), 6500 HB, Nijmegen, The Netherlands.

Background: An important and supposedly impactful form of clinical ethics support is moral case deliberation (MCD). Empirical evidence, however, is limited with regard to its actual impact. With this literature review, we aim to investigate the empirical evidence of MCD, thereby a) informing the practice, and b) providing a focus for further research on and development of MCD in healthcare settings. Read More

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https://bmcmedethics.biomedcentral.com/articles/10.1186/s129
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http://dx.doi.org/10.1186/s12910-018-0325-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6219174PMC
November 2018
9 Reads

Addressing vaccine hesitancy requires an ethically consistent health strategy.

BMC Med Ethics 2018 10 24;19(1):84. Epub 2018 Oct 24.

Biobehavioral Health Department, Pennsylvania State University, University Park, USA.

Background: Vaccine hesitancy is a growing threat to public health. The reasons are complex but linked inextricably to a lack of trust in vaccines, expertise and traditional sources of authority. Efforts to increase immunization uptake in children in many countries that have seen a fall in vaccination rates are two-fold: addressing hesitancy by improving healthcare professional-parent exchange and information provision in the clinic; and, secondly, public health strategies that can override parental concerns and values with coercive measures such as mandatory and presumptive vaccination. Read More

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https://bmcmedethics.biomedcentral.com/articles/10.1186/s129
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http://dx.doi.org/10.1186/s12910-018-0322-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6201581PMC
October 2018
16 Reads

Ethical considerations for HIV cure-related research at the end of life.

BMC Med Ethics 2018 10 20;19(1):83. Epub 2018 Oct 20.

Division of Infectious Diseases and Global Public Health, University of California San Diego, Stein Clinical Research Building, La Jolla, California, USA.

Background: The U.S. National Institute of Allergies and Infectious Diseases (NIAID) and the National Institute of Mental Health (NIMH) have a new research priority: inclusion of terminally ill persons living with HIV (PLWHIV) in HIV cure-related research. Read More

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https://bmcmedethics.biomedcentral.com/articles/10.1186/s129
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http://dx.doi.org/10.1186/s12910-018-0321-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6196016PMC
October 2018
23 Reads

Conscientious objection to intentional killing: an argument for toleration.

BMC Med Ethics 2018 10 19;19(1):82. Epub 2018 Oct 19.

Centre for Medical Ethics, Institute of Health and Society, University of Oslo, NO-0318, Oslo, Norway.

Background: In the debate on conscientious objection in healthcare, proponents of conscience rights often point to the imperative to protect the health professional's moral integrity. Their opponents hold that the moral integrity argument alone can at most justify accommodation of conscientious objectors as a "moral courtesy", as the argument is insufficient to establish a general moral right to accommodation, let alone a legal right.

Main Text: This text draws on political philosophy in order to argue for a legal right to accommodation. Read More

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http://dx.doi.org/10.1186/s12910-018-0323-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6194637PMC
October 2018
1 Read

Exploring neurologists' perspectives on the return of next generation sequencing results to their patients: a needed step in the development of guidelines.

BMC Med Ethics 2018 09 29;19(1):81. Epub 2018 Sep 29.

Institut de recherche en santé publique, Université de Montréal, PO Box 6128, Station Centre-ville, Montreal, Quebec, H3C 3J7, Canada.

Background: The use of Next Generation Sequencing such as Whole Genome Sequencing (WGS) is a promising step towards a better understanding and treatment of neurological diseases. WGS can result into unexpected information (incidental findings, IFs), and information with uncertain clinical significance. In the context of a Genome Canada project on 'Personalized Medicine in the Treatment of Epilepsy', we intended to address these challenges surveying neurologists' opinions about the type of results that should be returned, and their professional responsibility toward recontacting patients regarding new discovered mutations. Read More

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http://dx.doi.org/10.1186/s12910-018-0320-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6162934PMC
September 2018
3 Reads

Attitudes to prenatal screening among Norwegian citizens: liberality, ambivalence and sensitivity.

BMC Med Ethics 2018 09 18;19(1):80. Epub 2018 Sep 18.

Department of Fetal Medicine, Division of Obstetrics and Gynecology, Oslo University Hospital and University of Oslo, Oslo, Norway.

Background: Norway's liberal abortion law allows for abortion on social indications, yet access to screening for fetal abnormalities is restricted. Norwegian regulation of, and public discourse about prenatal screening and diagnosis has been exceptional. In this study, we wanted to investigate whether the exceptional regulation is mirrored in public attitudes. Read More

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http://dx.doi.org/10.1186/s12910-018-0319-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6145324PMC
September 2018
2 Reads

What information and the extent of information research participants need in informed consent forms: a multi-country survey.

BMC Med Ethics 2018 09 15;19(1):79. Epub 2018 Sep 15.

Department of Endocrinology, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGI), Lucknow, Uttar Pradesh, India.

Background: The use of lengthy, detailed, and complex informed consent forms (ICFs) is of paramount concern in biomedical research as it may not truly promote the rights and interests of research participants. The extent of information in ICFs has been the subject of debates for decades; however, no clear guidance is given. Thus, the objective of this study was to determine the perspectives of research participants about the type and extent of information they need when they are invited to participate in biomedical research. Read More

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http://dx.doi.org/10.1186/s12910-018-0318-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6139128PMC
September 2018
11 Reads
1.600 Impact Factor

A bioethical framework to guide the decision-making process in the care of seriously ill patients.

BMC Med Ethics 2018 08 20;19(1):78. Epub 2018 Aug 20.

Department of Legal Medicine and Medical Ethics, Medicine School, University of São Paulo, São Paulo, Brazil.

Background: One of the biggest challenges of practicing medicine in the age of informational technology is how to conciliate the overwhelming amount of medical-scientific information with the multiple patients' values of modern pluralistic societies. To organize and optimize the the Decision-Making Process (DMP) of seriously ill patient care, we present a framework to be used by Healthcare Providers. The objective is to align Bioethics, Evidence-based Practice and Person-centered Care. Read More

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http://dx.doi.org/10.1186/s12910-018-0317-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6102884PMC
August 2018
13 Reads

Reuse of cardiac organs in transplantation: an ethical analysis.

BMC Med Ethics 2018 08 17;19(1):77. Epub 2018 Aug 17.

Department of Biomedical Ethics, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.

Background: This paper examines the ethical aspects of organ transplant surgery in which a donor heart is transplanted from a first recipient, following determination of death by neurologic criteria, to a second recipient. Retransplantation in this sense differs from that in which one recipient undergoes repeat heart transplantation of a newly donated organ, and is thus referred to here as "reuse cardiac organ transplantation."

Methods: Medical, legal, and ethical analysis, with a main focus on ethical analysis. Read More

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http://dx.doi.org/10.1186/s12910-018-0316-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6098651PMC
August 2018
17 Reads

Frequency of use of the religious exemption in New Jersey cases of determination of brain death.

BMC Med Ethics 2018 08 14;19(1):76. Epub 2018 Aug 14.

Northeastern University, 371 Holmes Hall, 360 Huntington Ave, Boston, MA, 02115, USA.

Background: The 1981 Uniform Determination of Death Act (UDDA) established the validity of both cardio-respiratory and neurological criteria of death. However, many religious traditions including most forms of Haredi Judaism (ultra-orthodox) and many varieties of Buddhism strongly disagree with death by neurological criteria (DNC). Only one state in the U. Read More

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http://dx.doi.org/10.1186/s12910-018-0315-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6092846PMC
August 2018
2 Reads

The values and ethical commitments of doctors engaging in macroallocation: a qualitative and evaluative analysis.

BMC Med Ethics 2018 07 24;19(1):75. Epub 2018 Jul 24.

Faculty of Medicine and Health, Health and Medical Humanities, Sydney Health Ethics, Medical Foundation Building K25, University of Sydney, Sydney, NSW, 2006, Australia.

Background: In most socialised health systems there are formal processes that manage resource scarcity and determine the allocation of funds to health services in accordance with their priority. In this analysis, part of a larger qualitative study examining the ethical issues entailed in doctors' participation as technical experts in priority setting, we describe the values and ethical commitments of doctors who engage in priority setting and make an empirically derived contribution towards the identification of an ethical framework for doctors' macroallocation work.

Method: We conducted semi-structured interviews with 20 doctors, each of whom participated in macroallocation at one or more levels of the Australian health system. Read More

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http://dx.doi.org/10.1186/s12910-018-0314-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6056994PMC
July 2018
2 Reads

Beyond 'health and safety' - the challenges facing students asked to work outside of their comfort, qualification level or expertise on medical elective placement.

BMC Med Ethics 2018 07 20;19(1):74. Epub 2018 Jul 20.

University of Birmingham, Birmingham, UK.

Background: On elective students may not always be clear about safeguarding themselves and others. It is important that placements are safe, and ethically grounded. A concern for medical schools is equipping their students for exposure to and response to uncomfortable and/or unfamiliar requests in locations away from home, where their comfort and safety, or that of the patient, may be compromised. Read More

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http://dx.doi.org/10.1186/s12910-018-0307-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6053783PMC
July 2018
3 Reads

A systematic review of the literature on ethical aspects of transitional care between child- and adult-orientated health services.

BMC Med Ethics 2018 07 18;19(1):73. Epub 2018 Jul 18.

Lucena Clinic Rathgar , Dublin 6, Republic of Ireland.

Background: Healthcare policy and academic literature have promoted improving the transitional care of young people leaving child and adolescent mental health services (CAMHS). Despite the availability of guidance on good practice, there seems to be no readily accessible, coherent ethical analysis of transition. The ethical principles of non-maleficence, beneficence, justice and respect for autonomy can be used to justify the need for further enquiry into the ethical pros and cons of this drive to improve transitional care. Read More

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http://dx.doi.org/10.1186/s12910-018-0276-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6052672PMC
July 2018
3 Reads

Setting standards for empirical bioethics research: a response to Carter and Cribb.

BMC Med Ethics 2018 07 13;19(1):66. Epub 2018 Jul 13.

Institute for Medical Ethics and History of Medicine, Martin-Luther-University Halle-Wittenberg, Halle, Germany.

This paper responds to the commentaries from Stacy Carter and Alan Cribb. We pick up on two main themes in our response. First, we reflect on how the process of setting standards for empirical bioethics research entails drawing boundaries around what research counts as empirical bioethics research, and we discuss whether the standards agreed in the consensus process draw these boundaries correctly. Read More

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http://dx.doi.org/10.1186/s12910-018-0302-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6044088PMC
July 2018
4 Reads

Debating diversity: a commentary on Standards of practice in empirical bioethics research.

Authors:
Stacy M Carter

BMC Med Ethics 2018 07 12;19(1):67. Epub 2018 Jul 12.

Research for Social Change, Faculty of Social Science, Building 233, G05, Innovation Campus, The University of Wollongong, Wollongong, 2522, Australia.

This article provides a commentary on Standards of practice in empirical bioethics research by Ives and colleagues (in this Issue). There is much to admire in the paper, and in the demanding consensus-building process on which it reports. I discuss the problems and limits of methodological standardisation, and a central conceptual tension that appears to have divided participants. Read More

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http://dx.doi.org/10.1186/s12910-018-0306-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6042341PMC
July 2018
3 Reads

Predictors of consent to cell line creation and immortalisation in a South African schizophrenia genomics study.

BMC Med Ethics 2018 07 11;19(1):72. Epub 2018 Jul 11.

Mailman School of Public Health, Columbia University and New York State Psychiatric Institute, New York, USA.

Background: Cell line immortalisation is a growing component of African genomics research and biobanking. However, little is known about the factors influencing consent to cell line creation and immortalisation in African research settings. We contribute to addressing this gap by exploring three questions in a sample of Xhosa participants recruited for a South African psychiatric genomics study: First, what proportion of participants consented to cell line storage? Second, what were predictors of this consent? Third, what questions were raised by participants during this consent process?

Methods: 760 Xhose people with schizophrenia and 760 controls were matched to sex, age, level of education and recruitment region. Read More

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http://dx.doi.org/10.1186/s12910-018-0313-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6042361PMC
July 2018
10 Reads
1.600 Impact Factor

Let's talk about standards: a commentary on standards of practice in empirical bioethics.

Authors:
Alan Cribb

BMC Med Ethics 2018 07 11;19(1):69. Epub 2018 Jul 11.

King's College London, London, UK.

This commentary welcomes the work of Ives et al. on Standards of practice in Empirical Bioethics, and especially the dialogical spirit in which the standards have been constructed and offered. It also raises some questions about the consistent interpretation and use of such standards. Read More

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http://dx.doi.org/10.1186/s12910-018-0303-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6040063PMC
July 2018
3 Reads

Standards of practice in empirical bioethics research: towards a consensus.

BMC Med Ethics 2018 07 10;19(1):68. Epub 2018 Jul 10.

VU Medical Centre, Amsterdam, Netherlands.

Background: This paper reports the process and outcome of a consensus finding project, which began with a meeting at the Brocher Foundation in May 2015. The project sought to generate and reach consensus on standards of practice for Empirical Bioethics research. The project involved 16 academics from 5 different European Countries, with a range of disciplinary backgrounds. Read More

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http://dx.doi.org/10.1186/s12910-018-0304-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6038185PMC
July 2018
3 Reads

Their view: difficulties and challenges of patients and physicians in cross-cultural encounters and a medical ethics perspective.

BMC Med Ethics 2018 07 4;19(1):70. Epub 2018 Jul 4.

Universitätsspital Basel, Hebelstrasse 2, CH-4031, Basel, Switzerland.

Background: In todays' super-diverse societies, communication and interaction in clinical encounters are increasingly shaped by linguistic, cultural, social and ethnic complexities. It is crucial to better understand the difficulties patients with migration background and healthcare professionals experience in their shared clinical encounters and to explore ethical aspects involved.

Methods: We accompanied 32 migrant patients (16 of Albanian and Turkish origin each) during their medical encounters at two outpatient clinics using an ethnographic approach (participant observation and semi-structured interviews with patients and healthcare professionals). Read More

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http://dx.doi.org/10.1186/s12910-018-0311-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6033281PMC
July 2018
4 Reads

Ethics of task shifting in the health workforce: exploring the role of community health workers in HIV service delivery in low- and middle-income countries.

BMC Med Ethics 2018 07 4;19(1):71. Epub 2018 Jul 4.

Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.

Background: Task shifting is increasingly used to address human resource shortages impacting HIV service delivery in low- and middle-income countries. By shifting basic tasks from higher- to lower-trained cadres, such as Community Health Workers (CHWs), task shifting can reduce overhead costs, improve community outreach, and provide efficient scale-up of essential treatments like antiretroviral therapies. Although there is rich evidence outlining positive outcomes that CHWs bring into HIV programs, important questions remain over their place in service delivery. Read More

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http://dx.doi.org/10.1186/s12910-018-0312-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6032788PMC
July 2018
8 Reads
1.600 Impact Factor

Management of financial conflicts of interests in clinical practice guidelines in Germany: results from the public database GuidelineWatch.

BMC Med Ethics 2018 06 28;19(1):65. Epub 2018 Jun 28.

Department of Neurology, Schlosspark-Klinik, Berlin, Germany.

Background: The reliability of clinical practice guidelines has been disputed because guideline panel members are often burdened with financial conflicts of interest (COI). Current recommendations for COI regulation advise not only detailed declaration but also active management of conflicts. To continuously assess COI declaration and management in German guidelines we established the public database LeitlinienWatch (GuidelineWatch). Read More

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http://dx.doi.org/10.1186/s12910-018-0309-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6022410PMC
June 2018
3 Reads

Integrated primary health care in low- and middle-income countries: a double challenge.

Authors:
Thomas Druetz

BMC Med Ethics 2018 06 15;19(Suppl 1):48. Epub 2018 Jun 15.

Department of Tropical Medicine, Tulane University, 1440 Canal St, New Orleans, LA, USA.

Background: The lack of primary healthcare integration has been identified as one of the main limits to programs' efficacy in low- and middle-income countries. This is especially relevant to the Millennium Development Goals, whose health objectives were not attained in many countries at their term in 2015. While global health scholars and decision-makers are unanimous in calling for integration, the objective here is to go further and contribute to its promotion by presenting two of the most important challenges to be met for its achievement: 1) developing a "crosswise approach" to implementation that is operational and effective; and 2) creating synergy between national programs and interventions driven by non-State actors. Read More

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http://dx.doi.org/10.1186/s12910-018-0288-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6020002PMC
June 2018
10 Reads

Ethical issues related to human papillomavirus vaccination programs: an example from Bangladesh.

BMC Med Ethics 2018 06 15;19(Suppl 1):39. Epub 2018 Jun 15.

Independent Consultant, Dhaka, Bangladesh.

Background: Human Papilloma Virus (HPV) vaccine was introduced in Bangladesh through the arrangement of a demonstration project in Gazipur district in 2016, targeting grade five female students and non-school going girls (age range 10-12 years). HPV vaccination is expected to be eventually included in the nationwide immunization program if the demonstration project is successful. However, introduction and implementation of such a vaccination program raises various ethical concerns. Read More

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http://dx.doi.org/10.1186/s12910-018-0287-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6019993PMC
June 2018
4 Reads

Commodification of care and its effects on maternal health in the Noun division (West Region - Cameroon).

BMC Med Ethics 2018 06 15;19(Suppl 1):43. Epub 2018 Jun 15.

Department of Sociology and Anthropology, University of Maroua, Maroua, Cameroon.

Background: Since the mid-1980s, there has been a gradual ethical drift in the provision of maternal care in African health facilities in general, and in Cameroon in particular, despite government efforts. In fact, in Cameroon, an increasing number of caregivers are reportedly not providing compassionate care in maternity services. Consequently, many women, particularly the financially vulnerable, experience numerous difficulties in accessing these health services. Read More

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http://dx.doi.org/10.1186/s12910-018-0286-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6019987PMC
June 2018
14 Reads

A reflection on the challenge of protecting confidentiality of participants while disseminating research results locally.

BMC Med Ethics 2018 06 15;19(Suppl 1):45. Epub 2018 Jun 15.

University of Montreal Public Health Research Institute, Montreal, Canada.

Background: Researchers studying health systems in low-income countries face a myriad of ethical challenges throughout the entire research process. In this article, we discuss one of the greatest ethical challenges that we encountered during our fieldwork in West Africa: the difficulty of protecting the confidentiality of participants (or groups of participants) while locally disseminating results of health systems research to stakeholders.

Methods: This reflection is based on experiences of authors involved in conducting evaluative research of interventions aimed at improving health systems in West Africa. Read More

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http://dx.doi.org/10.1186/s12910-018-0279-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6020006PMC
June 2018
3 Reads