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    622 results match your criteria BMC Medical Ethics [Journal]

    1 OF 13

    In pursuit of goodness in bioethics: analysis of an exemplary article.
    BMC Med Ethics 2018 Jun 15;19(1):60. Epub 2018 Jun 15.
    Centre for Medical Ethics, University of Oslo, PO Box 1130, Blindern, N-0318, Oslo, Norway.
    Background: What is good bioethics? Addressing this question is key for reinforcing and developing the field. In particular, a discussion of potential quality criteria can heighten awareness and contribute to the quality of bioethics publications. Accordingly, the objective of this article is threefold: first, we want to identify a set of criteria for quality in bioethics. Read More

    Evaluation as institution: a contractarian argument for needs-based economic evaluation.
    BMC Med Ethics 2018 Jun 13;19(1):59. Epub 2018 Jun 13.
    Department of Health Care Management, Institute of Public Health and Nursing Research, Health Sciences, University of Bremen, Bremen, Germany.
    Background: There is a gap between health economic evaluation methods and the value judgments of coverage decision makers, at least in Germany. Measuring preference satisfaction has been claimed to be inappropriate for allocating health care resources, e.g. Read More

    Advance directive: does the GP know and address what the patient wants? Advance directive in primary care.
    BMC Med Ethics 2018 Jun 11;19(1):58. Epub 2018 Jun 11.
    Department of Public Health and Primary Care, University of Leuven, Kapucijnenvoer 33, block J, Box 7001, 3000, Leuven, Belgium.
    Background: Due to the rapid changes in the medical world and the aging population, the need for advanced care planning grows. Despite efforts to make this topic discussed, only a minority of patients discusses the advance directive with their general practitioner (GP). This study aimed to map thresholds: What barriers are identified by GPs and patients in preparing and discussing an advance directive?

    Methods: A cross section survey in patients and GP's was performed. Read More

    Opening the debate on deep brain stimulation for Alzheimer disease - a critical evaluation of rationale, shortcomings, and ethical justification.
    BMC Med Ethics 2018 Jun 11;19(1):41. Epub 2018 Jun 11.
    Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department for Psychiatry and Psychotherapy, CCM, Division of Mind and Brain Research, Charitéplatz 1, 10117, Berlin, Germany.
    Background: Deep brain stimulation (DBS) as investigational intervention for symptomatic relief from Alzheimer disease (AD) has generated big expectations. Our aim is to discuss the ethical justification of this research agenda by examining the underlying research rationale as well as potential methodological pitfalls. The shortcomings we address are of high ethical importance because only scientifically valid research has the potential to be ethical. Read More

    Identification of ethics committees based on authors' disclosures: cross-sectional study of articles published in the European Journal of Anaesthesiology and a survey of ethics committees.
    BMC Med Ethics 2018 Jun 8;19(1):57. Epub 2018 Jun 8.
    Division of Anaesthesiology, Department of Anaesthesiology, Pharmacology and Intensive Care Medicine, Geneva University Hospitals, Rue Gabrielle Perret-Gentil 4, 1205, Geneva, Switzerland.
    Background: Since 2010, the European Journal of Anaesthesiology has required the reporting of five items concerning ethical approval in articles describing human research: ethics committee's name and address, chairperson's name, study's protocol number and approval date. We aimed to assess whether this requirement has helped to identify and to contact the referenced ethics committees.

    Methods: In this cross-sectional study, we analysed articles requiring ethical approval, according to the Swiss federal law for human research and published in the European Journal of Anaesthesiology in 2011. Read More

    Medicine, market and communication: ethical considerations in regard to persuasive communication in direct-to-consumer genetic testing services.
    BMC Med Ethics 2018 Jun 5;19(1):56. Epub 2018 Jun 5.
    Department of Medical Ethics and History of Medicine, University Medical Center Göttingen, Humboldtallee 36, 37073, Göttingen, Germany.
    Background: Commercial genetic testing offered over the internet, known as direct-to-consumer genetic testing (DTC GT), currently is under ethical attack. A common critique aims at the limited validation of the tests as well as the risk of psycho-social stress or adaption of incorrect behavior by users triggered by misleading health information. Here, we examine in detail the specific role of advertising communication of DTC GT companies from a medical ethical perspective. Read More

    The significance of ethics reflection groups in mental health care: a focus group study among health care professionals.
    BMC Med Ethics 2018 Jun 5;19(1):54. Epub 2018 Jun 5.
    Centre for Medical Ethics, Institute of Health and Society, Faculty of Medicine, University of Oslo, P.O.Box 1130, Blindern, NO-0318, Oslo, Norway.
    Background: Professionals within the mental health services face many ethical dilemmas and challenging situations regarding the use of coercion. The purpose of this study was to evaluate the significance of participating in systematic ethics reflection groups focusing on ethical challenges related to coercion.

    Methods: In 2013 and 2014, 20 focus group interviews with 127 participants were conducted. Read More

    Leadership in palliative medicine: moral, ethical and educational.
    BMC Med Ethics 2018 Jun 5;19(1):55. Epub 2018 Jun 5.
    Visiting Research Fellow, School of History, Anthropology, Politics and Philosophy, Queen's University Belfast, Belfast, UK.
    Background: Making particular use of Shale's analysis, this paper discusses the notion of leadership in the context of palliative medicine. Whilst offering a critical perspective, I build on the philosophy of palliative care offered by Randall and Downie and suggest that the normative structure of this medical speciality has certain distinctive features, particularly when compared to that of medicine more generally. I discuss this in terms of palliative medicine's distinctive morality or ethos, albeit one that should still be seen in terms of medical morality or the ethos of medicine. Read More

    The dual use of research ethics committees: why professional self-governance falls short in preserving biosecurity.
    BMC Med Ethics 2018 Jun 5;19(1):53. Epub 2018 Jun 5.
    Institute of Ethics and History of Medicine, University Medicine Greifswald, Ellernholzstr. 1-2, 17487, Greifswald, Germany.
    Background: Dual Use Research of Concern (DURC) constitutes a major challenge for research practice and oversight on the local, national and international level. The situation in Germany is shaped by two partly competing suggestions of how to regulate security-related research: The German Ethics Council, as an independent political advisory body, recommended a series of measures, including national legislation on DURC. Competing with that, the German National Academy of Sciences and the German Research Foundation, as two major professional bodies, presented a strategy which draws on the self-control of science and, inter alia, suggests expanding the scope of research ethics committees (RECs) to an evaluation of DURC. Read More

    The patient perspective in health care networks.
    BMC Med Ethics 2018 Jun 5;19(1):52. Epub 2018 Jun 5.
    Ghent University Hospital, Corneel Heymanslaan 10, Ghent, Belgium.
    Background: Health care organization is entering a new age. Focus is increasingly shifting from individual health care institutions to interorganizational collaboration and health care networks. Much hope is set on such networks which have been argued to improve economic efficiency and quality of care. Read More

    Surgical informed consent in obstetric and gynecologic surgeries: experience from a comprehensive teaching hospital in Southern Ethiopia.
    BMC Med Ethics 2018 May 24;19(1):38. Epub 2018 May 24.
    School of Public Health, College of Medicine and Health Sciences, Hawassa University, P.O.Box 70, Hawassa, Ethiopia.
    Background: Surgical Informed Consent (SIC) has long been recognized as an important component of modern medicine. The ultimate goals of SIC are to improve clients' understanding of the intended procedure, increase client satisfaction, maintain trust between clients and health providers, and ultimately minimize litigation issues related to surgical procedures. The purpose of the current study is to assess the comprehensiveness of the SIC process for women undergoing obstetric and gynecologic surgeries. Read More

    Research ethics review at University Eduardo Mondlane (UEM)/Maputo Central Hospital, Mozambique (2013-2016): a descriptive analysis of the start-up of a new research ethics committee (REC).
    BMC Med Ethics 2018 May 23;19(1):37. Epub 2018 May 23.
    Vanderbilt University Medical Center, Nashville, TN, USA.
    Background: Mozambique has seen remarkable growth in biomedical research over the last decade. To meet a growing need, the National Committee for Bioethics in Health of Mozambique (CNBS) encouraged the development of ethical review processes at institutions that regularly conduct medical and social science research. In 2012, the Faculty of Medicine (FM) of University Eduardo Mondlane (UEM) and the Maputo Central Hospital (MCH) established a joint Institutional Committee on Bioethics for Health (CIBS FM & MCH). Read More

    A scoping review of reporting 'Ethical Research Practices' in research conducted among refugees and war-affected populations in the Arab world.
    BMC Med Ethics 2018 May 15;19(1):36. Epub 2018 May 15.
    Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
    Background: Ethical research conduct is a cornerstone of research practice particularly when research participants include vulnerable populations. This study mapped the extent of reporting ethical research practices in studies conducted among refugees and war-affected populations in the Arab World, and assessed variations by time, country of study, and study characteristics.

    Methods: An electronic search of eight databases resulted in 5668 unique records published between 2000 and 2013. Read More

    Translating and culturally adapting the shortened version of the Hospital Ethical Climate Survey (HECS-S) - retaining or modifying validated instruments.
    BMC Med Ethics 2018 May 10;19(1):35. Epub 2018 May 10.
    Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
    Background: The Hospital Ethical Climate Survey (HECS) was developed in the USA and later shortened (HECS-S). HECS has previously been translated into Swedish and the aim of this study was to describe a process of translating and culturally adapting HECS-S and to develop a Swedish multi-professional version, relevant for paediatrics. Another aim was to describe decisions about retaining versus modifying the questionnaire in order to keep the Swedish version as close as possible to the original while achieving a good functional level and trustworthiness. Read More

    Involvement in decisions about intravenous treatment for nursing home patients: nursing homes versus hospital wards.
    BMC Med Ethics 2018 May 8;19(1):34. Epub 2018 May 8.
    Centre for Medical Ethics, Institute of Health and Society, Faculty of Medicine, University of Oslo, P.O box 1130 Blindern, 0318, Oslo, Norway.
    Background: Many of the elderly in nursing homes are very ill and have a reduced quality of life. Life expectancy is often hard to predict. Decisions about life-prolonging treatment should be based on a professional assessment of the patient's best interest, assessment of capacity to consent, and on the patient's own wishes. Read More

    Complexity of consenting for medical termination of pregnancy: prospective and longitudinal study in Paris.
    BMC Med Ethics 2018 May 2;19(1):33. Epub 2018 May 2.
    Department of Gynecology and Obstetrics, Hôtel-Dieu de France University Hospital, Boulevard Alfred Naccache, Achrafieh, P.O. Box: 16-6926, Beirut, Lebanon.
    Background: We analyzed the patients' perception of prenatal diagnosis of fetal cardiac pathology, and the reasons for choosing to continue with pregnancy despite being eligible to receive a medical termination of pregnancy. We also identified the challenges, the motives interfering in decision-making, and the consequences of the decisions on pregnancy, child and mother.

    Methods: This descriptive, prospective and longitudinal study was conducted in France, amongst pregnant women who wished to continue their pregnancy despite an unfavorable medical advice (incurable fetal cardiac pathologies). Read More

    The involvement of Canadian physicians in promoting and providing unproven and unapproved stem cell interventions.
    BMC Med Ethics 2018 May 2;19(1):32. Epub 2018 May 2.
    Osgoode Professional Development, Osgoode Hall Law School, York University, Toronto, Canada.
    Background: Direct to consumer offerings of unproven stem cell interventions (SCIs) is a pressing scientific and policy issue. According to media reports, providers of SCIs have emerged in Canada. This study provides the first systematic scan of Canadian providers and associated trends and claims. Read More

    Conscientious objection to participation in abortion by midwives and nurses: a systematic review of reasons.
    BMC Med Ethics 2018 Apr 27;19(1):31. Epub 2018 Apr 27.
    , Oberhausen-Berg, Germany.
    Background: Freedom of conscience is a core element of human rights respected by most European countries. It allows abortion through the inclusion of a conscience clause, which permits opting out of providing such services. However, the grounds for invoking conscientious objection lack clarity. Read More

    Patenting human genes: Chinese academic articles' portrayal of gene patents.
    BMC Med Ethics 2018 Apr 24;19(1):29. Epub 2018 Apr 24.
    Faculty of Law, University of Macau, E32, Avenida da Universidade, SAR, Taipa, Macau.
    Background: The patenting of human genes has been the subject of debate for decades. While China has gradually come to play an important role in the global genomics-based testing and treatment market, little is known about Chinese scholars' perspectives on patent protection for human genes.

    Methods: A content analysis of academic literature was conducted to identify Chinese scholars' concerns regarding gene patents, including benefits and risks of patenting human genes, attitudes that researchers hold towards gene patenting, and any legal and policy recommendations offered for the gene patent regime in China. Read More

    'Screening audit' as a quality assurance tool in good clinical practice compliant research environments.
    BMC Med Ethics 2018 Apr 25;19(1):30. Epub 2018 Apr 25.
    Human research Protection Center, Severance Hospital, Yonsei University Health System, Seoul, Korea.
    Background: With the growing amount of clinical research, regulations and research ethics are becoming more stringent. This trend introduces a need for quality assurance measures for ensuring adherence to research ethics and human research protection beyond Institutional Review Board approval. Audits, one of the most effective tools for assessing quality assurance, are measures used to evaluate Good Clinical Practice (GCP) and protocol compliance in clinical research. Read More

    Rationing elective surgery for smokers and obese patients: responsibility or prognosis?
    BMC Med Ethics 2018 Apr 24;19(1):28. Epub 2018 Apr 24.
    Monash University, Wellington Road, Clayton, VIC, 3800, Australia.
    Background: In the United Kingdom (UK), a number of National Health Service (NHS) Clinical Commissioning Groups (CCG) have proposed controversial measures to restrict elective surgery for patients who either smoke or are obese. Whilst the nature of these measures varies between NHS authorities, typically, patients above a certain Body Mass Index (BMI) and smokers are required to lose weight and quit smoking prior to being considered eligible for elective surgery. Patients will be supported and monitored throughout this mandatory period to ensure their clinical needs are appropriately met. Read More

    Women's perspectives on the ethical implications of non-invasive prenatal testing: a qualitative analysis to inform health policy decisions.
    BMC Med Ethics 2018 Apr 16;19(1):27. Epub 2018 Apr 16.
    Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada.
    Background: Non-Invasive Prenatal Testing (NIPT) is a technology which provides information about fetal genetic characteristics (including sex) very early in pregnancy by examining fetal DNA obtained from a sample of maternal blood. NIPT is a morally complex technology that has advanced quickly to market with a strong push from industry developers, leaving many areas of uncertainty still to be resolved, and creating a strong need for health policy that reflects women's social and ethical values. We approach the need for ethical policy-making by studying the use of NIPT and emerging policy in the province of Ontario, Canada. Read More

    Forensic psychiatry, one subspecialty with two ethics? A systematic review.
    BMC Med Ethics 2018 Apr 10;19(1):25. Epub 2018 Apr 10.
    Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.
    Background: Forensic psychiatry is a particular subspecialty within psychiatry, dedicated in applying psychiatric knowledge and psychiatric training for particular legal purposes. Given that within the scope of forensic psychiatry, a third party usually intervenes in the patient-doctor relationship, an amendment of the traditional ethical principles seems justified.

    Results: Thus, 47 articles, two book chapters and the guidelines produced by the World Psychiatric Association, the American Association of Psychiatry and the Law, as well as by the Royal Australian and New Zealand College of psychiatrists, were analyzed. Read More

    Ethical principles and placebo-controlled trials - interpretation and implementation of the Declaration of Helsinki's placebo paragraph in medical research.
    BMC Med Ethics 2018 Mar 15;19(1):24. Epub 2018 Mar 15.
    Institute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.
    Background: In October 2013, the Declaration of Helsinki was revised a seventh time in its 50 year history. While it is the most widely accepted set of ethical principles for the protection of patients participating in medical research, the Declaration of Helsinki has also been subject of constant controversy. In particular, its paragraph on the use of placebo controls in clinical trials divides the research community into active-control and placebo orthodox proponents, both continuously demanding revisions of the Declaration of Helsinki in favour of their position. Read More

    Compassionate use programs in Italy: ethical guidelines.
    BMC Med Ethics 2018 Mar 9;19(1):22. Epub 2018 Mar 9.
    Direzione Scientifica, AUSL di Reggio Emilia-IRCCS, Viale Umberto I 50, Reggio Emilia, Italy.
    Background: This article proposes a retrospective analysis of a compassionate use (CU), using a case study of request for Avelumab for a patient suffering from Merkel Cell Carcinoma. The study is the result of a discussion within a Provincial Ethics Committee (EC) following the finding of a high number of requests for CU program. The primary objective of the study is to illustrate the specific ethical and clinical profiles that emerge from the compassionate use program (CUP) issue. Read More

    Educational video-assisted versus conventional informed consent for trauma-related debridement surgery: a parallel group randomized controlled trial.
    BMC Med Ethics 2018 Mar 9;19(1):23. Epub 2018 Mar 9.
    Division of Trauma and Surgical Critical Care, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
    Background: We investigated whether, in the emergency department (ED), educational video-assisted informed consent is superior to the conventional consent process, to inform trauma patients undergoing surgery about the procedure, benefits, risks, alternatives, and postoperative care.

    Methods: We conducted a prospective randomized controlled trial, with superiority study design. All trauma patients scheduled to receive trauma-related debridement surgery in the ED of Kaohsiung Medical University Hospital were included. Read More

    Patient data and patient rights: Swiss healthcare stakeholders' ethical awareness regarding large patient data sets - a qualitative study.
    BMC Med Ethics 2018 Mar 7;19(1):20. Epub 2018 Mar 7.
    Institute of Biomedical Ethics and Medical History (IBME), University of Zurich, Winterthurerstrasse 30, CH-8006, Zurich, Switzerland.
    Background: There is a growing interest in aggregating more biomedical and patient data into large health data sets for research and public benefits. However, collecting and processing patient data raises new ethical issues regarding patient's rights, social justice and trust in public institutions. The aim of this empirical study is to gain an in-depth understanding of the awareness of possible ethical risks and corresponding obligations among those who are involved in projects using patient data, i. Read More

    Early-career researchers' views on ethical dimensions of patient engagement in research.
    BMC Med Ethics 2018 Mar 7;19(1):21. Epub 2018 Mar 7.
    Bioethics Program, University of Montreal School of Public Health, Montreal, QC, Canada.
    Background: Increasing attention and efforts are being put towards engaging patients in health research, and some have even argued that patient engagement in research (PER) is an ethical imperative. Yet there is relatively little empirical data on ethical issues associated with PER.

    Methods: A three-round Delphi survey was conducted with a panel of early-career researchers (ECRs) involved in PER. Read More

    Leaving patients to their own devices? Smart technology, safety and therapeutic relationships.
    BMC Med Ethics 2018 Mar 6;19(1):18. Epub 2018 Mar 6.
    University of Bristol Law School, Wills Memorial Building, Bristol, BS8 1RJ, UK.
    Background: This debate article explores how smart technologies may create a double-edged sword for patient safety and effective therapeutic relationships. Increasing utilization of health monitoring devices by patients will likely become an important aspect of self-care and preventive medicine. It may also help to enhance accurate symptom reports, diagnoses, and prompt referral to specialist care where appropriate. Read More

    The ethics of using placebo in randomised controlled trials: a case study of a Plasmodium vivax antirelapse trial.
    BMC Med Ethics 2018 Mar 6;19(1):19. Epub 2018 Mar 6.
    Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
    Background: The use of placebos in randomised controlled trials is a subject of considerable ethical debate. In this paper we present a set of considerations to evaluate the ethics of placebo controlled trials that includes: social value of the study; need for a randomised controlled trial and placebo; standards of care; risks of harm due to administration of placebo and the harm benefit balance; clinical equipoise; and double standards. We illustrate the application of these considerations using a case study of a large ongoing multicentre, placebo-controlled, double-blinded, randomised trial to determine primaquine anti-relapse efficacy in vivax malaria. Read More

    Objectivity applied to embodied subjects in health care and social security medicine: definition of a comprehensive concept of cognitive objectivity and criteria for its application.
    BMC Med Ethics 2018 Mar 2;19(1):15. Epub 2018 Mar 2.
    Ansgar University College and Theological Seminary, Fredrik Fransonsvei 4, NO-4635, Kristiansand, Norway.
    Background: The article defines a comprehensive concept of cognitive objectivity (CCCO) applied to embodied subjects in health care. The aims of this study were: (1) to specify some necessary conditions for the definition of a CCCO that will allow objective descriptions and assessments in health care, (2) to formulate criteria for application of such a CCCO, and (3) to investigate the usefulness of the criteria in work disability assessments in medical certificates from health care provided for social security purposes.

    Methods: The study design was based on a philosophical conceptual analysis of objectivity and subjectivity, the phenomenological notions 'embodied subject', 'life-world', 'phenomenological object' and 'empathy', and an interpretation of certificates as texts. Read More

    Screening for infectious diseases of asylum seekers upon arrival: the necessity of the moral principle of reciprocity.
    BMC Med Ethics 2018 Mar 2;19(1):16. Epub 2018 Mar 2.
    Infectious Disease Unit, Department of Internal Medicine, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
    Background: With a large number of forcibly displaced people seeking safety, the EU is facing a challenge in maintaining solidarity. Europe has seen millions of asylum seekers crossing European borders, the largest number of asylum seekers since the second world war. Endemic diseases and often failing health systems in their countries of origin, and arduous conditions during transit, raise questions around how to meet the health needs of this vulnerable population on arrival in terms of screening, vaccination, and access to timely and appropriate statutory health services. Read More

    Matters to address prior to introducing new life support technology in Japan: three serious ethical concerns related to the use of left ventricular assist devices as destination therapy and suggested policies to deal with them.
    BMC Med Ethics 2018 Feb 27;19(1):12. Epub 2018 Feb 27.
    Department of Bioethics, Kumamoto University Faculty of Life Sciences, 1-1-1 Honjyo, Chuo-ku, Kumamoto, 860-8556, Japan.
    Background: Destination therapy (DT) is the permanent implantation of a left ventricular assist device (LVAD) in patients with end-stage, severe heart failure who are ineligible for heart transplantation. DT improves both the quality of life and prognosis of patients with end-stage heart failure. However, there are also downsides to DT such as life-threatening complications and the potential for the patient to live beyond their desired length of life following such major complications. Read More

    Ethical issues in pragmatic randomized controlled trials: a review of the recent literature identifies gaps in ethical argumentation.
    BMC Med Ethics 2018 Feb 27;19(1):14. Epub 2018 Feb 27.
    Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
    Background: Pragmatic randomized controlled trials (RCTs) are designed to evaluate the effectiveness of interventions in real-world clinical conditions. However, these studies raise ethical issues for researchers and regulators. Our objective is to identify a list of key ethical issues in pragmatic RCTs and highlight gaps in the ethics literature. Read More

    Rules of engagement: perspectives on stakeholder engagement for genomic biobanking research in South Africa.
    BMC Med Ethics 2018 Feb 27;19(1):13. Epub 2018 Feb 27.
    Department of Medicine, Centre for Medical Ethics and Law, Faculty of Health Sciences, Stellenbosch University, Stellenbosch, South Africa.
    Background: Genomic biobanking research is undergoing exponential growth in Africa raising a host of legal, ethical and social issues. Given the scientific complexity associated with genomics, there is a growing recognition globally of the importance of science translation and community engagement (CE) for this type of research, as it creates the potential to build relationships, increase trust, improve consent processes and empower local communities. Despite this level of recognition, there is a lack of empirical evidence of the practise and processes for effective CE in genomic biobanking in Africa. Read More

    Ethical implications of digital communication for the patient-clinician relationship: analysis of interviews with clinicians and young adults with long term conditions (the LYNC study).
    BMC Med Ethics 2018 Feb 23;19(1):11. Epub 2018 Feb 23.
    Warwick Medical School, The University of Warwick, Coventry, CV4 7AL, UK.
    Background: Digital communication between a patient and their clinician offers the potential for improved patient care, particularly for young people with long term conditions who are at risk of service disengagement. However, its use raises a number of ethical questions which have not been explored in empirical studies. The objective of this study was to examine, from the patient and clinician perspective, the ethical implications of the use of digital clinical communication in the context of young people living with long-term conditions. Read More

    Moral dilemmas and conflicts concerning patients in a vegetative state/unresponsive wakefulness syndrome: shared or non-shared decision making? A qualitative study of the professional perspective in two moral case deliberations.
    BMC Med Ethics 2018 Feb 22;19(1):10. Epub 2018 Feb 22.
    Radboud University Medical Centre, department of primary care, Nijmegen, The Netherlands.
    Background: Patients in a vegetative state/ unresponsive wakefulness syndrome (VS/UWS) pose ethical dilemmas to those involved. Many conflicts occur between professionals and families of these patients. In the Netherlands physicians are supposed to withdraw life sustaining treatment once recovery is not to be expected. Read More

    Advance directives as a tool to respect patients' values and preferences: discussion on the case of Alzheimer's disease.
    BMC Med Ethics 2018 Feb 20;19(1). Epub 2018 Feb 20.
    Bioethics Unit, IRCCS Centro San Giovanni di Dio Fatebenefratelli, Via Pilastroni, 4 - 25125, Brescia, Italy.
    Background: The proposal of the new criteria for the diagnosis of Alzheimer's disease (AD) based on biomarker data is making possible a diagnosis of AD at the mild cognitive impairment (MCI) or predementia/prodromal- stage. Given the present lack of effective treatments for AD, the opportunity for the individuals to personally take relevant decisions and plan for their future before and if cognitive deterioration occurs is one the main advantages of an early diagnosis.

    Main Body: Advance directives are largely seen as an effective tool for planning medical care in the event the subject becomes incompetent. Read More

    Disparate compensation policies for research related injury in an era of multinational trials: a case study of Brazil, Russia, India, China and South Africa.
    BMC Med Ethics 2018 Feb 17;19(1). Epub 2018 Feb 17.
    Centre for Medical Ethics and Law, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town, 8000, South Africa.
    Background: Compensation for research related injuries is a subject that is increasingly gaining traction in developing countries which are burgeoning destinations of multi center research. However, the existence of disparate compensation rules violates the ethical principle of fairness. The current paper presents a comparison of the policies of Brazil, Russia, India, China and South Africa (BRICS). Read More

    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

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