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    580 results match your criteria BMC Medical Ethics [Journal]

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    Benefit in liver transplantation: a survey among medical staff, patients, medical students and non-medical university staff and students.
    BMC Med Ethics 2018 Feb 12;19(1). Epub 2018 Feb 12.
    Department of General, Visceral, Vascular and Transplant Surgery, Klinikum der Universität München, Marchioninistrasse 15, 81377, München, Germany.
    Background: The allocation of any scarce health care resource, especially a lifesaving resource, can create profound ethical and legal challenges. Liver transplant allocation currently is based upon urgency, a sickest-first approach, and does not utilize capacity to benefit. While urgency can be described reasonably well with the MELD system, benefit encompasses multiple dimensions of patients' well-being. Read More

    An update on the "empirical turn" in bioethics: analysis of empirical research in nine bioethics journals.
    BMC Med Ethics 2018 Feb 7;19(1). Epub 2018 Feb 7.
    Institute for Biomedical Ethics, University of Basel, Basel, Switzerland.
    Background: A review of literature published a decade ago noted a significant increase in empirical papers across nine bioethics journals. This study provides an update on the presence of empirical papers in the same nine journals. It first evaluates whether the empirical trend is continuing as noted in the previous study, and second, how it is changing, that is, what are the characteristics of the empirical works published in these nine bioethics journals. Read More

    Combining value of information analysis and ethical argumentation in decisions on participation of vulnerable patients in clinical research.
    BMC Med Ethics 2018 Feb 5;19(1). Epub 2018 Feb 5.
    Department of Health Evidence (133), Radboud University Medical Centre, PO Box 9101, 6500HB, Nijmegen, The Netherlands.
    Background: The participation of vulnerable patients in clinical research poses apparent ethical dilemmas. Depending on the nature of the vulnerability, their participation may challenge the ethical principles of autonomy, non-maleficence, or justice. On the other hand, non-participation may preclude the building of a knowledge base that is a prerequisite for defining the optimal clinical management of vulnerable patients. Read More

    Fake facts and alternative truths in medical research.
    BMC Med Ethics 2018 Jan 27;19(1). Epub 2018 Jan 27.
    The Institute for the Health Sciences, Norwegian University of Science and Technology (NTNU), PO Box 1, N-2802, Gjøvik, Norway.
    Background: Fake news and alternative facts have become commonplace in these so-called "post-factual times." What about medical research - are scientific facts fake as well? Many recent disclosures have fueled the claim that scientific facts are suspect and that science is in crisis. Scientists appear to engage in facting interests instead of revealing interesting facts. Read More

    Autonomy and couples' joint decision-making in healthcare.
    BMC Med Ethics 2018 Jan 11;19(1). Epub 2018 Jan 11.
    Department of Bioethics, Clinical Center, Building, 10/1C118, National Institutes of Health, Bethesda, MD, 20892-1156, USA.
    Background: Respect for autonomy is a key principle in bioethics. However, respecting autonomy in practice is complex because most people define themselves and make decisions influenced by a complex network of social relationships. The extent to which individual autonomy operates for each partner within the context of decision-making within marital or similar relationships is largely unexplored. Read More

    "Right to recommend, wrong to require"- an empirical and philosophical study of the views among physicians and the general public on smoking cessation as a condition for surgery.
    BMC Med Ethics 2018 Jan 8;19(1). Epub 2018 Jan 8.
    Stockholm Centre for Healthcare Ethics (CHE), LIME, Karolinska Institutet, Tomtebodavägen 18 A, 171 77, Stockholm, Sweden.
    Background: In many countries, there are health care initiatives to make smokers give up smoking in the peri-operative setting. There is empirical evidence that this may improve some, but not all, operative outcomes. However, it may be feared that some support for such policies stems from ethically questionable opinions, such as paternalism or anti-smoker sentiments. Read More

    Ethical aspects of diagnosis and interventions for children with fetal alcohol Spectrum disorder (FASD) and their families.
    BMC Med Ethics 2018 Jan 5;19(1). Epub 2018 Jan 5.
    Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU), Stockholm, Sweden.
    Background: Fetal alcohol spectrum disorders (FASD) is an umbrella term covering several conditions for which alcohol consumption during pregnancy is taken to play a causal role. The benefit of individuals being identified with a condition within FASD remains controversial. The objective of the present study was to identify ethical aspects and consequences of diagnostics, interventions, and family support in relation to FASD. Read More

    Balancing the local and the universal in maintaining ethical access to a genomics biobank.
    BMC Med Ethics 2017 12 28;18(1):80. Epub 2017 Dec 28.
    MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Crewe Road South, Edinburgh, Scotland, EH4 2XU, UK.
    Background: Issues of balancing data accessibility with ethical considerations and governance of a genomics research biobank, Generation Scotland, are explored within the evolving policy landscape of the past ten years. During this time data sharing and open data access have become increasingly important topics in biomedical research. Decisions around data access are influenced by local arrangements for governance and practices such as linkage to health records, and the global through policies for biobanking and the sharing of data with large-scale biomedical research data resources and consortia. Read More

    The use of empirical research in bioethics: a survey of researchers in twelve European countries.
    BMC Med Ethics 2017 12 22;18(1):79. Epub 2017 Dec 22.
    Bioethics Institute Ghent, University of Ghent, Ghent, Belgium.
    Background: The use of empirical research methods in bioethics has been increasing in the last decades. It has resulted in discussions about the 'empirical turn of bioethics' and raised questions related to the value of empirical work for this field, methodological questions about its quality and rigor, and how this integration of the normative and the empirical can be achieved. The aim of this paper is to describe the attitudes of bioethics researchers in this field towards the use of empirical research, and examine their actual conduct: whether they use empirical research methods (and if so, what methods), and whether (and how) they have made attempts at integrating the empirical and the normative. Read More

    Participatory improvement of a template for informed consent documents in biobank research - study results and methodological reflections.
    BMC Med Ethics 2017 Dec 20;18(1):78. Epub 2017 Dec 20.
    Institute for History, Ethics and Philosophy of Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
    Background: For valid informed consent, it is crucial that patients or research participants fully understand all that their consent entails. Testing and revising informed consent documents with the assistance of their addressees can improve their understandability. In this study we aimed at further developing a method for testing and improving informed consent documents with regard to readability and test-readers' understanding and reactions. Read More

    Ethical challenges experienced by UK military medical personnel deployed to Sierra Leone (operation GRITROCK) during the 2014-2015 Ebola outbreak: a qualitative study.
    BMC Med Ethics 2017 Dec 19;18(1):77. Epub 2017 Dec 19.
    Health Sciences, Warwick Medical School, University of Warwick, Gibbet Hill, Coventry, CV4 7AL, UK.
    Background: As part of its response to the 2014 Ebola outbreak in west Africa, the United Kingdom (UK) government established an Ebola treatment unit in Sierra Leone, staffed by military personnel. Little is known about the ethical challenges experienced by military medical staff on humanitarian deployment. We designed a qualitative study to explore this further with those who worked in the treatment unit. Read More

    Experiences of community members and researchers on community engagement in an Ecohealth project in South Africa and Zimbabwe.
    BMC Med Ethics 2017 Dec 13;18(1):76. Epub 2017 Dec 13.
    College of Health Sciences, University of KwaZulu Natal, 1st Floor George Campbell Building, King George V Ave, Durban, 4041, South Africa.
    Background: Community engagement (CE) models have provided much needed guidance for researchers to conceptualise and design engagement strategies for research projects. Most of the published strategies, however, still show very limited contribution of the community to the engagement process. One way of achieving this is to document experiences of community members in the CE processes during project implementation. Read More

    Decision-making on therapeutic futility in Mexican adolescents with cancer: a qualitative study.
    BMC Med Ethics 2017 Dec 11;18(1):74. Epub 2017 Dec 11.
    Policy Studies Centre of the College of Public Policy, University of Texas in San Antonio, San Antonio Texas, USA.
    Background: The world literature shows that empirical research regarding the process of decision-making when cancer in adolescents is no longer curable has been conducted in High-income, English speaking countries. The objective of the current study was to explore in-depth and to explain the decision-making process from the perspective of Mexican oncologists, parents, and affected adolescents and to identify the ethical principles that guide such decision-making.

    Methods: Purposive, qualitative design based on individual, fact-to-face, semi-structured, in-depth interviews. Read More

    The ethics of caring for hospital-dependent patients.
    BMC Med Ethics 2017 Dec 11;18(1):75. Epub 2017 Dec 11.
    Frank H. Netter MD School of Medicine at Quinnipiac University, 275 Mount Carmel Ave, Hamden, CT, 06518-1908, USA.
    Background: Hospital-dependent patients are individuals who are repeatedly readmitted to the hospital because their acute medical needs cannot be met elsewhere. Unlike the chronically critically ill, these patients do not have a continuous need for life-sustaining equipment and can experience periods of relative stability where they have a good quality of life. However, some end up spending months or even years in the hospital receiving resource-intensive care because they are unable to be safely discharged, despite an initial optimistic prognosis. Read More

    Must we remain blind to undergraduate medical ethics education in Africa? A cross-sectional study of Nigerian medical students.
    BMC Med Ethics 2017 Dec 8;18(1):73. Epub 2017 Dec 8.
    Department of Ophthalmology, College of Medicine, University of Nigeria, Ituku-Ozalla, Enugu, Enugu State, Nigeria.
    Background: As the practice of medicine inevitably raises both ethical and legal issues, it had been recommended since 1999 that medical ethics and human rights be taught at every medical school. Most Nigerian medical schools still lack a formal undergraduate medical ethics curriculum. Medical education remains largely focused on traditional medical science components, leaving the medical students to develop medical ethical decision-making skills and moral attitudes passively within institutions noted for relatively strong paternalistic traditions. Read More

    Transplant eligibility for patients with affective and psychotic disorders: a review of practices and a call for justice.
    BMC Med Ethics 2017 Dec 8;18(1):72. Epub 2017 Dec 8.
    NYU Langone Health, Division of Medical Ethics, New York, NY, USA.
    Background: The scarcity of human organs requires the transplant community to make difficult allocation decisions. This process begins at individual medical centers, where transplant teams decide which patients to place on the transplant waiting list. Each transplant center utilizes its own listing criteria to determine if a patient is eligible for transplantation. Read More

    Patient-targeted Googling and social media: a cross-sectional study of senior medical students.
    BMC Med Ethics 2017 Dec 4;18(1):70. Epub 2017 Dec 4.
    Section of Obstetrics and Gynaecology, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
    Background: Social media and Internet technologies present several emerging and ill-explored issues for a modern healthcare workforce. One issue is patient-targeted Googling (PTG), which involves a healthcare professional using a social networking site (SNS) or publicly available search engine to find patient information online. The study's aim was to address a deficit in data and knowledge regarding PTG, and to investigate medical student use of SNSs due to a close association with PTG. Read More

    Informed consent for clinical treatment in low-income setting: evaluating the relationship between satisfying consent and extent of recall of consent information.
    BMC Med Ethics 2017 Dec 2;18(1):69. Epub 2017 Dec 2.
    Department of Surgery, College of Medicine, University of Nigeria, Enugu Campus P M B, State, Enugu, 01129, Nigeria.
    Background: Treatment informed consent aims to preserve the autonomy of patients in the clinician - patient relationship so as to ensure valid consent. An acceptable method of evaluating understanding of consent information is by assessing the extent of recall by patients of the pieces information believed to have been passed across. When concerns are not satisfactorily addressed from the patients' perspective, recall of consent information may be low. Read More

    Roles and responsibilities of clinical ethics committees in priority setting.
    BMC Med Ethics 2017 Dec 1;18(1):68. Epub 2017 Dec 1.
    Centre for Medical Ethics, Institute of Health and Society, University of Oslo, Pb. 1130 Blindern, N-0318, Oslo, Norway.
    Background: Fair prioritization of healthcare resources has been on the agenda for decades, but resource allocation dilemmas in clinical practice remain challenging. Can clinical ethics committees (CECs) be of help? The aim of the study was to explore whether and how CECs handle priority setting dilemmas and contribute to raising awareness of fairness concerns.

    Method: Descriptions of activities involving priority setting in annual reports from Norwegian CECs (2003-2015) were studied and categorized through qualitative content analysis. Read More

    Development and pilot testing of an informed consent video for patients with limb trauma prior to debridement surgery using a modified Delphi technique.
    BMC Med Ethics 2017 Nov 29;18(1):67. Epub 2017 Nov 29.
    Division of Trauma and Surgical Critical Care, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
    Background: Ensuring adequate informed consent for surgery in a trauma setting is challenging. We developed and pilot tested an educational video containing information regarding the informed consent process for surgery in trauma patients and a knowledge measure instrument and evaluated whether the audiovisual presentation improved the patients' knowledge regarding their procedure and aftercare and their satisfaction with the informed consent process.

    Methods: A modified Delphi technique in which a panel of experts participated in successive rounds of shared scoring of items to forecast outcomes was applied to reach a consensus among the experts. Read More

    Ethical considerations in forensic genetics research on tissue samples collected post-mortem in Cape Town, South Africa.
    BMC Med Ethics 2017 Nov 29;18(1):66. Epub 2017 Nov 29.
    Department of Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925, South Africa.
    Background: The use of tissue collected at a forensic post-mortem for forensic genetics research purposes remains of ethical concern as the process involves obtaining informed consent from grieving family members. Two forensic genetics research studies using tissue collected from a forensic post-mortem were recently initiated at our institution and were the first of their kind to be conducted in Cape Town, South Africa.

    Main Body: This article discusses some of the ethical challenges that were encountered in these research projects. Read More

    Measuring inconsistency in research ethics committee review.
    BMC Med Ethics 2017 Nov 28;18(1):65. Epub 2017 Nov 28.
    Institute of Biomedical and Biomolecular Science, University of Portsmouth, King Henry Building, Portsmouth, PO1 2DY, UK.
    Background: The review of human participant research by Research Ethics Committees (RECs) or Institutional Review Boards (IRBs) is a complex multi-faceted process that cannot be reduced to an algorithm. However, this does not give RECs/ IRBs permission to be inconsistent in their specific requirements to researchers or in their final opinions. In England the Health Research Authority (HRA) coordinates 67 committees, and has adopted a consistency improvement plan including a process called "Shared Ethical Debate" (ShED) where multiple committees review the same project. Read More

    The no correlation argument: can the morality of conscientious objection be empirically supported? the Italian case.
    BMC Med Ethics 2017 Nov 21;18(1):64. Epub 2017 Nov 21.
    Department of Public Health and Pediatrics, University of Turin, Via Santena 5 bis, 10126, Torino, Italy.
    Background: The legitimacy of conscientious objection to abortion continues to fuel heated debate in Italy. In two recent decisions, the European Committee for Social Rights underlined that conscientious objection places safe, legal, and accessible care and services out of reach for most Italian women and that the measures that Italy has adopted to guarantee free access to abortion services are inadequate. Nevertheless, the Ministry of Health states that current Italian legislation, if appropriately applied, accommodates both the right to conscientious objection and the right to voluntary abortion. Read More

    Biobanking in Israel 2016-17; expressed perceptions versus real life enrollment.
    BMC Med Ethics 2017 Nov 17;18(1):63. Epub 2017 Nov 17.
    Research Institute, Maccabi Health Services, Tel Aviv, Israel.
    Background: As part of the preparations to establish a population-based biobank in a large Israeli health organization, we aimed to investigate through focus groups the knowledge, perceptions and attitudes of insured Israelis, toward biobanking, and then, after input from focus groups' participants, to empirically assess the impact of a revised recruitment process on recruitment rates.

    Methods: 1) Six Focus group discussions were conducted (n = 10 per group) with individuals who had routine blood laboratory tests taken in the last 2 years. 2) After addressing the issues raised in the focus groups and revising the recruitment process, individuals undergoing routine blood tests in phlebotomy clinics (N = 10,262) were invited to participate in the future biobank. Read More

    Gender and age disparity in the initiation of life-supporting treatments: a population-based cohort study.
    BMC Med Ethics 2017 Nov 15;18(1):62. Epub 2017 Nov 15.
    Graduate Institute of Medical Education and Bioethics, National Taiwan University College of Medicine, Taipei, Taiwan.
    Background: The relationships between age and the life-supporting treatments use, and between gender and the life-supporting treatments use are still controversial. Using extracorporeal membrane oxygenation as an example of life-supporting treatments, the objectives of this study were: (1) to examine the relationship between age and the extracorporeal membrane oxygenation use; (2) to examine the relationship between age and the extracorporeal membrane oxygenation use; and (3) to deliberate the ethical and societal implications of age and gender disparities in the initiation of extracorporeal membrane oxygenation.

    Methods: This is a population-based, retrospective cohort study. Read More

    Ethical aspects of brain computer interfaces: a scoping review.
    BMC Med Ethics 2017 Nov 9;18(1):60. Epub 2017 Nov 9.
    Neuroethics Research Unit, Institut de recherches cliniques de Montréal, 110 avenue des Pins Ouest, H2W lR7, Montréal, QC, Canada.
    Background: Brain-Computer Interface (BCI) is a set of technologies that are of increasing interest to researchers. BCI has been proposed as assistive technology for individuals who are non-communicative or paralyzed, such as those with amyotrophic lateral sclerosis or spinal cord injury. The technology has also been suggested for enhancement and entertainment uses, and there are companies currently marketing BCI devices for those purposes (e. Read More

    The strange case of Mr. H. Starting dialysis at 90 years of age: clinical choices impact on ethical decisions.
    BMC Med Ethics 2017 Nov 9;18(1):61. Epub 2017 Nov 9.
    Nephrology, Centre Hospitalier Le Mans, Avenue Roubillard, 72000, Le Mans, France.
    Background: Starting dialysis at an advanced age is a clinical challenge and an ethical dilemma. The advantages of starting dialysis at "extreme" ages are questionable as high dialysis-related morbidity induces a reflection on the cost- benefit ratio of this demanding and expensive treatment in a person that has a short life expectancy. Where clinical advantages are doubtful, ethical analysis can help us reach decisions and find adapted solutions. Read More

    The emergence of ethical issues in the provision of online sexual health outreach for gay, bisexual, two-spirit and other men who have sex with men: perspectives of online outreach workers.
    BMC Med Ethics 2017 Nov 3;18(1):59. Epub 2017 Nov 3.
    Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, M5S 1V4, Canada.
    Background: Mobile applications and socio-sexual networking websites are used by outreach workers to respond synchronously to questions and provide information, resources, and referrals on sexual health and STI/HIV prevention, testing, and care to gay, bisexual and other men who have sex with men (GB2M). This exploratory study examined ethical issues identified by online outreach workers who conduct online sexual health outreach for GB2M.

    Methods: Semi-structured individual interviews were conducted between November 2013 and April 2014 with online providers and managers (n = 22) to explore the benefits, challenges, and ethical implications of delivering online outreach services in Ontario, Canada. Read More

    This moral coil: a cross-sectional survey of Canadian medical student attitudes toward medical assistance in dying.
    BMC Med Ethics 2017 Oct 27;18(1):58. Epub 2017 Oct 27.
    Michael G. DeGroote School of Medicine, Waterloo Regional Campus, McMaster University, 10B Victoria St S, Kitchener, ON, N2G 1C5, Canada.
    Background: In February, 2015, the Supreme Court of Canada struck down the ban on medical assistance in dying (MAiD). In June, 2016, the federal government passed Bill C-14, permitting MAiD. Current medical students will be the first physician cohort to enter a system permissive of MAiD, and may help to ensure equitable access to care. Read More

    Collaborative partnership and the social value of clinical research: a qualitative secondary analysis.
    BMC Med Ethics 2017 Oct 25;18(1):57. Epub 2017 Oct 25.
    Department of Nursing Science, University of Eastern Finland, Kuopio Campus, P.O. Box 1627, 70211, Kuopio, Finland.
    Background: Protecting human subjects from being exploited is one of the main ethical challenges for clinical research. However, there is also a responsibility to protect and respect the communities who are hosting the research. Recently, attention has focused on the most efficient way of carrying out clinical research, so that it benefits society by providing valuable research while simultaneously protecting and respecting the human subjects and the communities where the research is conducted. Read More

    Limits to human enhancement: nature, disease, therapy or betterment?
    BMC Med Ethics 2017 Oct 10;18(1):56. Epub 2017 Oct 10.
    Norwegian University of Science and Technology (NTNU), Gjøvik, Norway.
    Background: New technologies facilitate the enhancement of a wide range of human dispositions, capacities, or abilities. While it is argued that we need to set limits to human enhancement, it is unclear where we should find resources to set such limits.

    Discussion: Traditional routes for setting limits, such as referring to nature, the therapy-enhancement distinction, and the health-disease distinction, turn out to have some shortcomings. Read More

    What is a good health check? An interview study of health check providers' views and practices.
    BMC Med Ethics 2017 Oct 2;18(1):55. Epub 2017 Oct 2.
    Department of Medical Ethics and Philosophy, ErasmusMC, Na building, room Na 21.197 Postbus, 2040 3000, CA, Rotterdam, The Netherlands.
    Background: Health checks identify (risk factors for) disease in people without symptoms. They may be offered by the government through population screenings and by other providers to individual users as 'personal health checks'. Health check providers' perspective of 'good' health checks may further the debate on the ethical evaluation and possible regulation of these personal health checks. Read More

    Descriptive study of association between quality of care and empathy and burnout in primary care.
    BMC Med Ethics 2017 Sep 26;18(1):54. Epub 2017 Sep 26.
    Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain.
    Background: The doctor-patient relationship is a crucial aspect of primary-care practice Research on associations between quality of care provision and burnout and empathy in a primary care setting could improve this relationship.

    Methods: Cross-sectional study of family physicians (108) and nurses (112) of twenty-two primary care centers in the health district of Lleida, Spain. Empathy and burnout were measured using the Jefferson Physician Empathy Scale and the Maslach Burnout Inventory, while quality of care delivery was evaluated using Quality Standard Indicator scores. Read More

    Informed consent and registry-based research - the case of the Danish circumcision registry.
    BMC Med Ethics 2017 Sep 15;18(1):53. Epub 2017 Sep 15.
    University of Manchester, Centre for Social Ethics and Policy, School of Law, Manchester, M13 9PL, UK.
    Background: Research into personal health data holds great potential not only for improved treatment but also for economic growth. In these years many countries are developing policies aimed at facilitating such research often under the banner of 'big data'. A central point of debate is whether the secondary use of health data requires informed consent if the data is anonymised. Read More

    Eliciting meta consent for future secondary research use of health data using a smartphone application - a proof of concept study in the Danish population.
    BMC Med Ethics 2017 Aug 15;18(1):51. Epub 2017 Aug 15.
    Centre for Social Ethicse and Policy, School of Law, University of Manchester, M13 9PL, Manchester, UK.
    Background: The increased use of information technology in every day health care creates vast amounts of stored health data that can be used for research. The secondary research use of routinely collected data raises questions about appropriate consent mechanisms for such use. One option is meta consent where individuals state their own consent preferences in relation to future use of their data, e. Read More

    Ethical issues of informed consent in malaria research proposals submitted to a research ethics committee in Thailand: a retrospective document review.
    BMC Med Ethics 2017 Aug 14;18(1):50. Epub 2017 Aug 14.
    Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Ratchawithi Road, Bangkok, 10400, Thailand.
    Background: The informed-consent process should be one of meaningful information exchange between researchers and study participants. One of the responsibilities of research ethics committees is to oversee appropriate informed consent. The committee must consider various matters before deciding whether the process is appropriate, including the adequacy and completeness of the written information provided to study participants, and the process of obtaining informed consent. Read More

    Does growing up with a physician influence the ethics of medical students' relationships with the pharmaceutical industry? The cases of the US and Poland.
    BMC Med Ethics 2017 Aug 10;18(1):49. Epub 2017 Aug 10.
    Warsaw University of Life Sciences, Faculty of Social Sciences, Ul. Nowoursynowska 166, 02-787, Warsaw, Poland.
    Background: Medical schools have a major impact on future doctors' ethics and their attitudes towards cooperation with the pharmaceutical industry. From childhood, medical students who are related to a physician are exposed to the characteristics of a medical career and learn its professional ethics not only in school but also in the family setting. The present paper sought to answer the research question: 'How does growing up with a physician influence medical students' perceptions of conflicts of interest in their relationships with industry?'

    Methods: An anonymous questionnaire was completed by 451 medical students from four Philadelphia medical schools and 554 medical students from Warsaw Medical University during 2013. Read More

    The Liverpool Care Pathway: discarded in cancer patients but good enough for dying nursing home patients? A systematic review.
    BMC Med Ethics 2017 08 9;18(1):48. Epub 2017 Aug 9.
    Norwegian National Advisory Unit on Ageing and Health (Ageing and Health), Vestfold hospital and Oslo universitet hospital, Ullevaal, Oslo, Norway.
    Background: The Liverpool Care Pathway (LCP) is an interdisciplinary protocol, aiming to ensure that dying patients receive dignified and individualized treatment and care at the end-of-life. LCP was originally developed in 1997 in the United Kingdom from a model of cancer care successfully established in hospices. It has since been introduced in many countries, including Norway. Read More

    Healthcare professionals' and patients' perspectives on consent to clinical genetic testing: moving towards a more relational approach.
    BMC Med Ethics 2017 Aug 8;18(1):47. Epub 2017 Aug 8.
    Clinical Ethics and Law, University of Southampton, Southampton General Hospital, South Academic Block, Tremona Road, Southampton, SO16 6YD, UK.
    Background: This paper proposes a refocusing of consent for clinical genetic testing, moving away from an emphasis on autonomy and information provision, towards an emphasis on the virtues of healthcare professionals seeking consent, and the relationships they construct with their patients.

    Methods: We draw on focus groups with UK healthcare professionals working in the field of clinical genetics, as well as in-depth interviews with patients who have sought genetic testing in the UK's National Health Service (data collected 2013-2015). We explore two aspects of consent: first, how healthcare professionals consider the act of 'consenting' patients; and second how these professional accounts, along with the accounts of patients, deepen our understanding of the consent process. Read More

    Pre- and post-testing counseling considerations for the provision of expanded carrier screening: exploration of European geneticists' views.
    BMC Med Ethics 2017 Aug 1;18(1):46. Epub 2017 Aug 1.
    Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care, KU Leuven - University of Leuven, Leuven, Belgium.
    Background: Carrier screening is generally performed with the aim of identifying healthy couples at risk of having a child affected with a monogenic disorder to provide them with reproductive options. Expanded carrier screening (ECS), which provides the opportunity for multiple conditions to be screened in one test, offers a more cost-effective and comprehensive option than screening for single disorders. However, implementation of ECS at a population level would have implications for genetic counseling practice. Read More

    Familiar ethical issues amplified: how members of research ethics committees describe ethical distinctions between disaster and non-disaster research.
    BMC Med Ethics 2017 Jun 28;18(1):44. Epub 2017 Jun 28.
    School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.
    Background: The conduct of research in settings affected by disasters such as hurricanes, floods and earthquakes is challenging, particularly when infrastructures and resources were already limited pre-disaster. However, since post-disaster research is essential to the improvement of the humanitarian response, it is important that adequate research ethics oversight be available.

    Methods: We aim to answer the following questions: 1) what do research ethics committee (REC) members who have reviewed research protocols to be conducted following disasters in low- and middle-income countries (LMICs) perceive as the key ethical concerns associated with disaster research?, and 2) in what ways do REC members understand these concerns to be distinct from those arising in research conducted in non-crisis situations? This qualitative study was developed using interpretative description methodology; 15 interviews were conducted with REC members. Read More

    Ethics review of studies during public health emergencies - the experience of the WHO ethics review committee during the Ebola virus disease epidemic.
    BMC Med Ethics 2017 Jun 26;18(1):43. Epub 2017 Jun 26.
    World Health Organization, 20 Avenue Appia, 1211, 27, Geneva, Switzerland.
    Background: Between 2013 and 2016, West Africa experienced the largest ever outbreak of Ebola Virus Disease. In the absence of registered treatments or vaccines to control this lethal disease, the World Health Organization coordinated and supported research to expedite identification of interventions that could control the outbreak and improve future control efforts. Consequently, the World Health Organization Research Ethics Review Committee (WHO-ERC) was heavily involved in reviews and ethics discussions. Read More

    Comparative effectiveness research: what to do when experts disagree about risks.
    BMC Med Ethics 2017 Jun 19;18(1):42. Epub 2017 Jun 19.
    Department of Bioethics, National Institutes of Health, 10 Center Drive, Bethesda, MD, 20892, USA.
    Background: Ethical issues related to comparative effectiveness research, or research that compares existing standards of care, have recently received considerable attention. In this paper we focus on how Ethics Review Committees (ERCs) should evaluate the risks of comparative effectiveness research.

    Main Text: We discuss what has been a prominent focus in the debate about comparative effectiveness research, namely that it is justified when "nothing is known" about the comparative effectiveness of the available alternatives. Read More

    Development of a consensus operational definition of child assent for research.
    BMC Med Ethics 2017 Jun 9;18(1):41. Epub 2017 Jun 9.
    Physical Medicine and Rehabilitation, University of Michigan Health System, 1500 E. Medical Center Dr, Ann Arbor, USA.
    Background: There is currently no consensus from the relevant stakeholders regarding the operational and construct definitions of child assent for research. As such, the requirements for assent are often construed in different ways, institutionally disparate, and often conflated with those of parental consent. Development of a standardized operational definition of assent would thus be important to ensure that investigators, institutional review boards, and policy makers consider the assent process in the same way. Read More

    Are advance directives helpful for good end of life decision making: a cross sectional survey of health professionals.
    BMC Med Ethics 2017 Jun 5;18(1):40. Epub 2017 Jun 5.
    Department of Social Sciences and Humanities, Medical Academy Lithuanian University of Health Sciences, Mickevičiaus g. 9, Kaunas, LT-44307, Lithuania.
    Background: This paper joins the debate over changes in the role of health professionals when applying advance directives to manage the decision-making process at the end of life care. Issues in relation to advance directives occur in clinical units in Lithuania; however, it remains one of the few countries in the European Union (EU) where the discussion on advance directives is not included in the health-care policy-making agenda. To encourage the discussion of advance directives, a study was designed to examine health professionals' understanding and preferences related to advance directives. Read More

    How Chinese clinicians face ethical and social challenges in fecal microbiota transplantation: a questionnaire study.
    BMC Med Ethics 2017 May 31;18(1):39. Epub 2017 May 31.
    Medical Center for Digestive Diseases, Second Affiliated Hospital of Nanjing Medical University, Nanjing, China.
    Background: Fecal microbiota transplantation (FMT) is reportedly the most effective therapy for relapsing Clostridium Difficile infection (CDI) and a potential therapeutic option for many diseases. It also poses important ethical concerns. This study is an attempt to assess clinicians' perception and attitudes towards ethical and social challenges raised by fecal microbiota transplantation. Read More

    A 14-day limit for bioethics: the debate over human embryo research.
    BMC Med Ethics 2017 May 30;18(1):38. Epub 2017 May 30.
    Department of Global Health & Social Medicine, King's College London, London, UK.
    Background: This article explores the reasons in favour of revising and extending the current 14-day statutory limit to maintaining human embryos in culture. This limit is enshrined in law in over a dozen countries, including the United Kingdom. In two recently published studies (2016), scientists have shown that embryos can be sustained in vitro for about 13 days after fertilisation. Read More

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