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R. Forde [19]Reidun Forde [1]
  1. J. Schildmann, B. Molewijk, L. Benaroyo, R. Forde & G. Neitzke (2013). Evaluation of Clinical Ethics Support Services and its Normativity. Journal of Medical Ethics 39 (11):681-685.
    Evaluation of clinical ethics support services (CESS) has attracted considerable interest in recent decades. However, few evaluation studies are explicit about normative presuppositions which underlie the goals and the research design of CESS evaluation. In this paper, we provide an account of normative premises of different approaches to CESS evaluation and argue that normativity should be a focus of considerations when designing and conducting evaluation research of CESS. In a first step, we present three different approaches to CESS evaluation from (...)
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  2. R. Forde & R. Pedersen (2012). Evaluation of Case Consultations in Clinical Ethics Committees. Clinical Ethics 7 (1):45-50.
    If ethics consultation services influence medical decisions it is important to evaluate how ethical dilemmas are dealt with by clinical ethics committees (CECs). Such evaluation is rare. This study presents a feasible and practical method of evaluating case discussions in CECs and the results emerging from the use of this method. A written presentation of an end-of-life dilemma was sent to all Norwegian ethics committees. The committees were asked to deal with the case as they would do if it was (...)
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  3. K. M. Agledahl, P. Gulbrandsen, R. Forde & A. Wifstad (2011). Courteous but Not Curious: How Doctors' Politeness Masks Their Existential Neglect. A Qualitative Study of Video-Recorded Patient Consultations. Journal of Medical Ethics 37 (11):650-654.
    Objective To study how doctors care for their patients, both medically and as fellow humans, through observing their conduct in patient–doctor encounters. Design Qualitative study in which 101 videotaped consultations were observed and analysed using a Grounded Theory approach, generating explanatory categories through a hermeneutical analysis of the taped consultations. Setting A 500-bed general teaching hospital in Norway. Participants 71 doctors working in clinical non-psychiatric departments and their patients. Results The doctors were concerned about their patients' health and how their (...)
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  4. A. Dreyer, R. Forde & P. Nortvedt (2011). Ethical Decision-Making in Nursing Homes: Influence of Organizational Factors. Nursing Ethics 18 (4):514-525.
    In this article we report findings from a qualitative study that explored how doctors and nurses in nursing homes describe professional collaboration around dying patients. The study also examined the consequences this can have for the life-prolonging treatment of patients and the care of them and their relatives. Nine doctors and 10 nurses from 10 Norwegian nursing homes were interviewed about their experience of decision-making processes on life-prolonging treatment and care. The findings reveal that the frameworks for the professional collaboration (...)
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  5. A. Dreyer, R. Forde & P. Nortvedt (2010). Life-Prolonging Treatment in Nursing Homes: How Do Physicians and Nurses Describe and Justify Their Own Practice? Journal of Medical Ethics 36 (7):396-400.
    Background Making the right decisions, while simultaneously showing respect for patient autonomy, represents a great challenge to nursing home staff in the issues of life-prolonging treatment, hydration, nutrition and hospitalisation to dying patents in end-of-life. Objectives To study how physicians and nurses protect nursing home patients' autonomy in end-of-life decisions, and how they justify their practice. Design A qualitative descriptive design with analysis of the content of transcribed in-depth interviews with physicians and nurses. Participants Nine physicians and ten nurses in (...)
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  6. A. Dreyer, R. Forde & P. Nortvedt (2009). Autonomy at the End of Life: Life-Prolonging Treatment in Nursing Homes--Relatives' Role in the Decision-Making Process. Journal of Medical Ethics 35 (11):672-677.
    Background: The increasing number of elderly people in nursing homes with failing competence to give consent represents a great challenge to healthcare staff’s protection of patient autonomy in the issues of life-prolonging treatment, hydration, nutrition and hospitalisation. The lack of national guidelines and internal routines can threaten the protection of patient autonomy. Objectives: To place focus on protecting patient autonomy in the decision-making process by studying how relatives experience their role as substitute decision-makers. Design: A qualitative descriptive design with analysis (...)
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  7. R. Forde & T. W. R. Hansen (2009). Involving Patients and Relatives in a Norwegian Clinical Ethics Committee: What Have We Learned? Clinical Ethics 4 (3):125-130.
    To date, few Norwegian clinical ethics committees (CECs) have included patients or next of kin in case discussions. In 2008, Rikshospitalet's (The National Hospital's) CEC began to routinely invite patients and relatives into case discussions. In this paper, we describe seven cases discussed by this committee in 2008. Six involved life and death decision-making in collaboration with the next of kin, while one related case did not include relatives. In our opinion, representing the patient's perspective was advantageous to the discussion (...)
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  8. V. Fournier, E. Rari, R. Forde, G. Neitzke, R. Pegoraro & A. J. Newson (2009). Clinical Ethics Consultation in Europe: A Comparative and Ethical Review of the Role of Patients. Clinical Ethics 4 (3):131-138.
    Clinical ethics has developed significantly in Europe over the past 15 years and remains an evolving process. While sharing our experiences in different European settings, we were surprised to discover marked differences in our practice, especially regarding the position and role of patients. In this paper, we describe these differences, such as patient access to and participation or representation in ethics consults. We propose reasons to explain these differences, hypothesizing that they relate to the historic and sociocultural context of implementation (...)
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  9. K. Halvorsen, R. Forde & P. Nortvedt (2009). The Principle of Justice in Patient Priorities in the Intensive Care Unit: The Role of Significant Others. Journal of Medical Ethics 35 (8):483-487.
    Background: Theoretically, the principle of justice is strong in healthcare priorities both nationally and internationally. Research, however, has indicated that questions can be raised as to how this principle is dealt with in clinical intensive care. Objective: The objective of this article is to examine how significant others may affect the principle of justice in the medical treatment and nursing care of intensive care patients. Method: Field observations and in-depth interviews with physicians and nurses in intensive care units (ICU). Emphasis (...)
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  10. M. Mangset, E. Berge, R. Forde, J. Nessa & T. B. Wyller (2009). "Two Per Cent Isn't a Lot, but When It Comes to Death It Seems Quite a Lot Anyway": Patients' Perception of Risk and Willingness to Accept Risks Associated with Thrombolytic Drug Treatment for Acute Stroke. Journal of Medical Ethics 35 (1):42-46.
    Background: Thrombolytic drugs to treat an acute ischaemic stroke reduce the risk of death or major disability. The treatment is, however, also associated with an increased risk of potentially fatal intracranial bleeding. This confronts the patient with the dilemma of whether or not to take a risk of a serious side effect in order to increase the likelihood of a favourable outcome. Objective: To explore acute stroke patients’ perception of risk and willingness to accept risks associated with thrombolytic drug treatment. (...)
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  11. R. Pedersen, V. Akre & R. Forde (2009). What is Happening During Case Deliberations in Clinical Ethics Committees? A Pilot Study. Journal of Medical Ethics 35 (3):147-152.
    Background: Clinical ethics consultation services have been established in many countries during recent decades. An important task is to discuss concrete clinical cases. However, empirical research observing what is happening during such deliberations is scarce. Objectives: To explore clinical ethics committees’ deliberations and to identify areas for improvement. Design: A pilot study including observations of committees deliberating a paper case, semistructured group interviews, and qualitative analysis of the data. Participants: Nine hospital ethics committees in Norway. Results and interpretations: Key elements (...)
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  12. R. Forde & O. G. Aasland (2008). Moral Distress Among Norwegian Doctors. Journal of Medical Ethics 34 (7):521-525.
    Background: Medicine is full of value conflicts. Limited resources and legal regulations may place doctors in difficult ethical dilemmas and cause moral distress. Research on moral distress has so far been mainly studied in nurses. Objective: To describe whether Norwegian doctors experience stress related to ethical dilemmas and lack of resources, and to explore whether the doctors feel that they have good strategies for the resolution of ethical dilemmas. Design: Postal survey of a representative sample of 1497 Norwegian doctors in (...)
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  13. S. A. Hurst, S. Reiter-Theil, A.-M. Slowther, R. Pegoraro, R. Forde & M. Danis (2008). Should Ethics Consultants Help Clinicians Face Scarcity in Their Practice? Journal of Medical Ethics 34 (4):241-246.
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  14. S. A. Hurst, Stella Reiter-Theil, A. M. Slowther, R. Pegoraro, R. Forde & Marion Danis (2008). Should Ethics Consultants Help Clinicians Face Scarcity in Their Practice? Journal of Medical Ethics 34 (4):241-246.
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  15. M. Mangset, R. Forde, J. Nessa, E. Berge & T. B. Wyller (2008). "I Don't Like That, It's Tricking People Too Much...": Acute Informed Consent to Participation in a Trial of Thrombolysis for Stroke. Journal of Medical Ethics 34 (10):751-756.
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  16. S. A. Hurst, A. Perrier, R. Pegoraro, S. Reiter-Theil, R. Forde, A.-M. Slowther, E. Garrett-Mayer & M. Danis (2007). Ethical Difficulties in Clinical Practice: Experiences of European Doctors. Journal of Medical Ethics 33 (1):51-57.
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  17. Samia A. Hurst, Stella Reiter-Theil, Arnaud Perrier, Reidun Forde, Anne-Marie Slowther, Renzo Pegoraro & Marion Danis (2007). Physicians' Access to Ethics Support Services in Four European Countries. Health Care Analysis 15 (4):321-335.
    Clinical ethics support services are developing in Europe. They will be most useful if they are designed to match the ethical concerns of clinicians. We conducted a cross-sectional mailed survey on random samples of general physicians in Norway, Switzerland, Italy, and the UK, to assess their access to different types of ethics support services, and to describe what makes them more likely to have used available ethics support. Respondents reported access to formal ethics support services such as clinical ethics committees (...)
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  18. S. Hurst, A. Perrier, R. Pegoraro, S. Reiter-Theil, R. Forde, A. Slowther, E. Garrett-Mayer & M. Danis (2006). European Physicians' Experience with Ethical Difficulties in Clinical Practice. Journal of Medical Ethics 33 (1):51-7.
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  19. R. Forde (2005). Clinical Ethics, Information, and Communication: Review of 31 Cases From a Clinical Ethics Committee. [REVIEW] Journal of Medical Ethics 31 (2):73-77.
    Objectives: To summarise the types of case brought to the Clinical Ethics Committee of the National Hospital of Norway from 1996 to 2002 and to describe and discuss to what extent issues of information/communication have been involved in the ethical problems. Design: Systematic review of case reports. Findings: Of the 31 case discussions, (20 prospective, 11 retrospective), 19 cases concerned treatment of children. Twenty cases concerned ethical problems related to withholding/withdrawing of treatment. In 25 cases aspects of information/communication were involved (...)
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  20. Ann Nordam, Venke Sørlie & R. Förde (2003). Integrity in the Care of Elderly People, as Narrated by Female Physicians. Nursing Ethics 10 (4):388-403.
    Three female physicians were interviewed as part of a comprehensive investigation into the narratives of female and male physicians and nurses, concerning their experience of being in ethically difficult care situations in the care of elderly people. The interviewees expressed great concern for the low status of care for elderly people, and the need to fight for the specialty and for the care and rights of their patients. All the interviewees’ narratives concerned problems relating to perspectives of both action ethics (...)
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