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  1. Ethics Framework for Citizen Science and Public and Patient Participation in Research.Tineke Abma & Barbara Groot - 2022 - BMC Medical Ethics 23 (1):1-9.
    BackgroundCitizen science and models for public participation in health research share normative ideals of participation, inclusion, and public and patient engagement. Academic researchers collaborate in research with members of the public involved in an issue, maximizing all involved assets, competencies, and knowledge. In citizen science new ethical issues arise, such as who decides, who participates, who is excluded, what it means to share power equally, or whose knowledge counts. This article aims to present an ethics framework that offers a lens (...)
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  2. Situational Judgment Using Ethical Reasoning in Saudi Undergraduate Pharmacy Students.Fahad Saleh Alkhuzaee, Majid Ali, Khang Wen Goh, Yaser Mohammed Al-Worafi & Long Chiau Ming - 2022 - BMC Medical Ethics 23 (1).
    Introduction There is a paramount need for moral development for pharmacists and pharmacy students to practice the patient-centered profession. We aimed to explore the current situational judgment utilizing ethical reasoning among undergraduate pharmacy students. Methods A set of ten ethical dilemmas, representing potential real-life situations that the students come across in the university and may face in the future as a pharmacist were developed by a team of students, academic staff, and stakeholders. These ethical dilemmas were validated, checked for accuracy, (...)
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  3. Perspectives on Returning Individual and Aggregate Genomic Research Results to Study Participants and Communities in Kenya: A Qualitative Study.Gershim Asiki, Michele Ramsay, Anita Ghansah, Paulina Tindana, Catherine Kyobutungi, Shukri F. Mohamed & Isaac Kisiangani - 2022 - BMC Medical Ethics 23 (1):1-11.
    BackgroundA fundamental ethical challenge in conducting genomics research is the question of what and how individual level genetic findings and aggregate genomic results should be conveyed to research participants and communities. This is within the context of minimal guidance, policies, and experiences, particularly in Africa. The aim of this study was to explore the perspectives of key stakeholders' on returning genomics research results to participants in Kenya.MethodsThis qualitative study involved focus group discussions and in-depth interviews with 69 stakeholders. The purposively (...)
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  4. What Does Coercion in Intensive Care Mean for Patients and Their Relatives? A Thematic Qualitative Study.Nicola Biller-Andorno, Bara Ricou, Rouven Porz, Corine Mouton Dorey & Susanne Jöbges - 2022 - BMC Medical Ethics 23 (1):1-15.
    BackgroundThe need for an ethical debate about the use of coercion in intensive care units may not be as obvious as in other areas of medicine, such as psychiatry. Coercive measures are often necessary to treat critically ill patients in the ICU. It is nevertheless important to keep these measures to a minimum in order to respect the dignity of patients and the cohesion of the clinical team. A deeper understanding of what patients and their relatives perceive during their ICU (...)
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  5. Dealing with Sexual Boundary Violation in Mental Healthcare Institutions by Government Policies: The Case of Flanders, Belgium.Johan Bilsen, Hubert Van Puyenbroeck, Dirk De Wachter, Frieda Matthys, Kim Dewilde & Lara Vesentini - 2022 - BMC Medical Ethics 23 (1).
    BackgroundTo prevent sexual boundary violations in mental health care institutions overall governments require these institutions to report SBV incidents to a central registry and to develop institutional guidelines how to react. In Europe SBV policies are only recently developed or implemented, as is also the case in Flanders. The implementation of a new institutional policy is always a challenge and can encounter resistance, especially when it concerns SBV, because they remain delicate and complex.MethodThis study evaluated the extent to which mandatory (...)
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  6. Experiences and Attitudes of Medical Professionals on Treatment of End-of-Life Patients in Intensive Care Units in the Republic of Croatia: A Cross-Sectional Study.Ana Borovečki, Dinko Tonković, Andrija Štajduhar, Mirjana Kujundžić Tiljak, Štefan Grosek, Mia Golubić, Bojana Nevajdić, Renata Krobot, Srđan Vranković, Jasminka Kopić, Igor Grubješić, Željko Župan, Krešimir Čaljkušić, Nenad Karanović, Višnja Nesek Adam, Zdravka Poljaković, Radovan Radonić, Tatjana Kereš, Vlasta Merc, Jasminka Peršec, Marinko Vučić & Diana Špoljar - 2022 - BMC Medical Ethics 23 (1):1-13.
    BackgroundDecisions about limitations of life sustaining treatments are made for end-of-life patients in intensive care units. The aim of this research was to explore the professional and ethical attitudes and experiences of medical professionals on treatment of end-of-life patients in ICUs in the Republic of Croatia.MethodsA cross-sectional study was conducted among physicians and nurses working in surgical, medical, neurological, and multidisciplinary ICUs in the total of 9 hospitals throughout Croatia using a questionnaire with closed and open type questions. Exploratory factor (...)
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  7.  1
    Ethics Education to Support Ethical Competence Learning in Healthcare: An Integrative Systematic Review.Anders Bremer, Mats Holmberg, Andreas Rantala, Catharina Frank, Anders Svensson & Henrik Andersson - 2022 - BMC Medical Ethics 23 (1):1-26.
    BackgroundEthical problems in everyday healthcare work emerge for many reasons and constitute threats to ethical values. If these threats are not managed appropriately, there is a risk that the patient may be inflicted with moral harm or injury, while healthcare professionals are at risk of feeling moral distress. Therefore, it is essential to support the learning and development of ethical competencies among healthcare professionals and students. The aim of this study was to explore the available literature regarding ethics education that (...)
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  8.  4
    Embedded Ethics: A Proposal for Integrating Ethics Into the Development of Medical AI.Alena Buyx, Sami Haddadin, Ruth Müller, Daniel Tigard, Amelia Fiske & Stuart McLennan - 2022 - BMC Medical Ethics 23 (1):1-10.
    The emergence of ethical concerns surrounding artificial intelligence has led to an explosion of high-level ethical principles being published by a wide range of public and private organizations. However, there is a need to consider how AI developers can be practically assisted to anticipate, identify and address ethical issues regarding AI technologies. This is particularly important in the development of AI intended for healthcare settings, where applications will often interact directly with patients in various states of vulnerability. In this paper, (...)
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  9. Health Professionals' Knowledge and Attitude Towards Patient Confidentiality and Associated Factors in a Resource-Limited Setting: A Cross-Sectional Study.Ashenafi Fentahun Chanie, Tirualem Zeleke, Wondewossen Zemene, Nebyu Demeke Mengestie, Tewabe Ambaye Ejigu, Meseret Gashaw Legese, Degefaw Denekew Hunegnaw, Aynadis Worku Shimie, Mequannent Sharew Melaku & Masresha Derese Tegegne - 2022 - BMC Medical Ethics 23 (1):1-10.
    BackgroundRespecting patients’ confidentiality is an ethical and legal responsibility for health professionals and the cornerstone of care excellence. This study aims to assess health professionals’ knowledge, attitudes, and associated factors towards patients’ confidentiality in a resource-limited setting.MethodsInstitutional based cross-sectional study was conducted among 423 health professionals. Stratified sampling methods were used to select the participants, and a structured self-administer questionnaire was used for data collection. The data was entered using Epi-data version 4.6 and analyzed using SPSS, version 25. Bi-variable and (...)
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  10. An Ethical Analysis of Clinical Triage Protocols and Decision-Making Frameworks: What Do the Principles of Justice, Freedom, and a Disability Rights Approach Demand of Us?Sunit Das, Chloë G. K. Atkins, Liam G. McCoy, Connor T. A. Brenna & Jane Zhu - 2022 - BMC Medical Ethics 23 (1):1-9.
    BackgroundThe expectation of pandemic-induced severe resource shortages has prompted authorities to draft and update frameworks to guide clinical decision-making and patient triage. While these documents differ in scope, they share a utilitarian focus on the maximization of benefit. This utilitarian view necessarily marginalizes certain groups, in particular individuals with increased medical needs.Main bodyHere, we posit that engagement with the disability critique demands that we broaden our understandings of justice and fairness in clinical decision-making and patient triage. We propose the capabilities (...)
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  11.  1
    Shifting to a Model of Donor Conception That Entails a Communication Agreement Among the Parents, Donor, and Offspring.Iñigo de Miguel Beriain & Tetsuya Ishii - 2022 - BMC Medical Ethics 23 (1):1-11.
    BackgroundSome persons conceived with donor gametes react negatively when they found their birth via donor conception. They request access to information about and seek to communicate with the donor. However, some countries mandate donor anonymity. Other countries allow donor-conceived persons to access donor information, but they can only use this access if their parents have disclosed donor conception to them. We investigated a thorny issue of donor conception: whether donor conception should be shifted from an anonymous basis to a non-anonymous (...)
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  12. Experimenting with Modifications to Consent Forms in Comparative Effectiveness Research: Understanding the Impact of Language About Financial Implications and Key Information.Neal W. Dickert, Yi-An Ko, Ofer Sadan, Andrea R. Mitchell, Gabriel Najarro, Candace D. Speight & Nyiramugisha K. Niyibizi - 2022 - BMC Medical Ethics 23 (1).
    BackgroundInformed consent forms are intended to facilitate research enrollment decisions. However, the technical language in institutional templates can be unfamiliar and confusing for decision-makers. Standardized language describing financial implications of participation, namely compensation for injury and costs of care associated with participating, can be complex and could be a deterrent for potential participants. This standardized language may also be misleading in the context of comparative effectiveness trials of standard care interventions, in which costs and risk of injury associated with participating (...)
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  13. Perceptions on Using Surplus Embryos for the Treatment of Parkinson’s Disease Among the Swedish Population: A Qualitative Study.Jennifer Drevin & Åsa Grauman - 2022 - BMC Medical Ethics 23 (1):1-9.
    BackgroundHuman embryonic stem cells are currently used for developing treatment against Parkinson’s disease. However, the use of ES cells is surrounded with moral concerns. Research regarding the public's attitudes can form an important basis for policymaking. The aim was to explore the perceptions of the public on using donated human embryos for developing treatment of Parkinson’s Disease.MethodsSemi-structured individual qualitative interviews were conducted with 11 members of the general population in Sweden. Interviews were analyzed with thematic content analyses.ResultsFour categories and additional (...)
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  14. Ethical and Practical Considerations for HIV Cure-Related Research at the End-of-Life: A Qualitative Interview and Focus Group Study in the United States.Karine Dubé, Davey Smith, Brandon Brown, Susan Little, Steven Hendrickx, Stephen A. Rawlings, Samuel Ndukwe, Hursch Patel, Christopher Christensen, Andy Kaytes, Jeff Taylor, Susanna Concha-Garcia, Sara Gianella & John Kanazawa - 2022 - BMC Medical Ethics 23 (1):1-17.
    BackgroundOne of the next frontiers in HIV research is focused on finding a cure. A new priority includes people with HIV with non-AIDS terminal illnesses who are willing to donate their bodies at the end-of-life to advance the search towards an HIV cure. We endeavored to understand perceptions of this research and to identify ethical and practical considerations relevant to implementing it.MethodsWe conducted 20 in-depth interviews and 3 virtual focus groups among four types of key stakeholders in the United States (...)
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  15. The Public Impact of Academic and Print Media Portrayals of TMS: Shining a Spotlight on Discrepancies in the Literature.Veljko Dubljević, Cynthia Rosenfeld & Abigail Scheper - 2022 - BMC Medical Ethics 23 (1):1-17.
    BackgroundTranscranial magnetic stimulation is an FDA approved treatment for major depression, migraine, obsessive compulsive disorder, and smoking addiction. TMS has gained popular media support, but media coverage and commercial reporting of TMS services may be contributing to the landscape of ethical issues.MethodsWe explore the differences between the academic and print media literature portrayals of TMS to evaluate their ethical impact for the public. We performed a comprehensive literature review using PubMed and NexisUni databases to evaluate the literature available on TMS (...)
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  16.  1
    It is Not a Big Deal: A Qualitative Study of Clinical Biobank Donation Experience and Motives.Ksenia Eritsyan & Natalia Antonova - 2022 - BMC Medical Ethics 23 (1):1-11.
    BackgroundThe success of biobanking is directly linked to the willingness of people to donate their biological materials for research and storage. Ethical issues related to patient consent are an essential component of the current biobanking agenda. The majority of data available are focused on population-based biobanks in USA, Canada and Western Europe. The donation decision process and its ethical applications in clinical populations and populations in countries with other cultural contexts are very limited. This study aimed to evaluate the decision-making (...)
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  17.  2
    Indicators and Criteria of Consciousness: Ethical Implications for the Care of Behaviourally Unresponsive Patients.Kathinka Evers, Benedetta Cecconi, Jitka Annen, Cyriel Pennartz & Michele Farisco - 2022 - BMC Medical Ethics 23 (1):1-15.
    BackgroundAssessing consciousness in other subjects, particularly in non-verbal and behaviourally disabled subjects, is notoriously challenging but increasingly urgent. The high rate of misdiagnosis among disorders of consciousness raises the need for new perspectives in order to inspire new technical and clinical approaches. Main bodyWe take as a starting point a recently introduced list of operational indicators of consciousness that facilitates its recognition in challenging cases like non-human animals and Artificial Intelligence to explore their relevance to disorders of consciousness and their (...)
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  18. What If Some Patients Are More “Important” Than Others? A Possible Framework for Covid-19 and Other Emergency Care Situations.Mirko D. Garasic & Andrea Lavazza - 2022 - BMC Medical Ethics 23 (1):1-11.
    BackgroundThe Covid-19 pandemic caused situations where, in some hospitals, there were more patients in need of urgent treatment in intensive care units than were available. In particular, there were not sufficient ventilators or critical care resources for all patients in danger of dying from respiratory failure or other organ failures.DiscussionAs the “first come, first served” criterion was not considered adequate, more nuanced and fairer clinical criteria were proposed to assess whom to treat first. One type of patients that has not (...)
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  19.  6
    Attitudes About Withholding or Withdrawing Life-Prolonging Treatment, Euthanasia, Assisted Suicide, and Physician Assisted Suicide: A Cross-Sectional Survey Among the General Public in Croatia.Chris Gastmans, Bert Gordijn, Diana Spoljar, Jurica Vukovic, Filip Rubic, Milivoj Novak, Stjepan Oreskovic, Krunoslav Nikodem, Marko Curkovic & Ana Borovecki - 2022 - BMC Medical Ethics 23 (1):1-16.
    BackgroundThere has been no in-depth research of public attitudes on withholding or withdrawing life-prolonging treatment, euthanasia, assisted suicide and physician assisted suicide in Croatia. The aim of this study was to examine these attitudes and their correlation with sociodemographic characteristics, religion, political orientation, tolerance of personal choice, trust in physicians, health status, experiences with death and caring for the seriously ill, and attitudes towards death and dying. MethodsA cross-sectional study was conducted on a three-stage random sample of adult citizens of (...)
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  20.  1
    Health Care Providers’ Ethical Perspectives on Waiver of Final Consent for Medical Assistance in Dying (MAiD): A Qualitative Study.Dianne Godkin, Lisa Cranley, Elizabeth Peter & Caroline Variath - 2022 - BMC Medical Ethics 23 (1):1-14.
    BackgroundWith the enactment of Bill C-7 in Canada in March 2021, people who are eligible for medical assistance in dying, whose death is reasonably foreseeable and are at risk of losing decision-making capacity, may enter into a written agreement with their healthcare provider to waive the final consent requirement at the time of provision. This study explored healthcare providers’ perspectives on honouring eligible patients’ request for MAiD in the absence of a contemporaneous consent following their loss of decision-making capacity. MethodA (...)
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  21. Patient-Centred Care and Patient Autonomy: Doctors’ Views in Chinese Hospitals.Peter Howard, Yongli Zhou, Guowei Liu, Min Xu & Zhanming Liang - 2022 - BMC Medical Ethics 23 (1).
    BackgroundPatient-centred care and patient autonomy is one of the key factors to better quality of service provision, hence patient outcomes. It enables the development of patients’ trusts which is an important element to a better doctor-patient relationship. Given the increasing number of patient disputes and conflicts between patients and doctors in Chinese public hospital, it is timely to ensure patient-centred care is fully and successfully implemented. However, limited studies have examined the views and practice in different aspects of patient-centred care (...)
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  22. The Effect of Deliberative Process on the Self-Sacrificial Decisions of Utilitarian Healthcare Students.Jungjoon Ihm, Minhae Cho, Seunghee Lee, Do-Hwan Kim, Seungmin Kim & Yongmin Shin - 2022 - BMC Medical Ethics 23 (1):1-10.
    BackgroundThe COVID-19 pandemic has highlighted prosocial behavior as a professional healthcare core competency. Although medical students are expected to work in the best interests of their patients, in the pandemic context, there is a greater need for ethical attention to be paid to the way medical students deal with moral dilemmas that may conflict with their obligations.MethodsThis study was conducted in the spring semester of 2019 on 271 students majoring in health professions: medicine, dentistry, and veterinary medicine. All participants provided (...)
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  23.  1
    A Qualitative Interview Study of Australian Physicians on Defensive Practice and Low Value Care: “It’s Easier to Talk About Our Fear of Lawyers Than to Talk About Our Fear of Looking Bad in Front of Each Other”.Jesse Jansen, Briony Johnston & Nola M. Ries - 2022 - BMC Medical Ethics 23 (1):1-14.
    BackgroundDefensive practice occurs when physicians provide services, such as tests, treatments and referrals, mainly to reduce their perceived legal or reputational risks, rather than to advance patient care. This behaviour is counter to physicians’ ethical responsibilities, yet is widely reported in surveys of doctors in various countries. There is a lack of qualitative research on the drivers of defensive practice, which is needed to inform strategies to prevent this ethically problematic behaviour.MethodsA qualitative interview study investigated the views and experiences of (...)
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  24. Ethical Considerations Around Volunteer Payments in a Malaria Human Infection Study in Kenya: An Embedded Empirical Ethics Study.Dorcas Kamuya, Vicki Marsh, Melissa Kapulu, Philip Bejon, Irene Jao, Esther Awuor Owino & Primus Che Chi - 2022 - BMC Medical Ethics 23 (1).
    Human Infection Studies have emerged as an important research approach with the potential to fast track the global development of vaccines and treatments for infectious diseases, including in low resource settings. Given the high level of burdens involved in many HIS, particularly prolonged residency and biological sampling requirements, it can be challenging to identify levels of study payments that provide adequate compensation but avoid ‘undue’ levels of inducement to participate. Through this embedded ethics study, involving 97 healthy volunteers and other (...)
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  25. A Chronological Discourse Analysis of Ancillary Care Provision in Guidance Documents for Research Conduct in the Global South.Blessings M. Kapumba, Nicola Desmond & Janet Seeley - 2022 - BMC Medical Ethics 23 (1).
    Introduction Numerous guidelines and policies for ethical research practice have evolved over time, how this translates to global health practice in resource-constrained settings is unclear. The purpose of this paper is to describe how the concept of ancillary care has evolved over time and how it is included in the ethics guidelines and policy documents that guide the conduct of research in the global south with both an international focus and providing a specific example of Malawi, where the first author (...)
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  26.  1
    Chinese Physicians’ Perceptions of Palliative Care Integration for Advanced Cancer Patients: A Qualitative Analysis at a Tertiary Hospital in Changsha, China.Xin Li, Kaveh Khoshnood, Xing Liu, Xin Chen, Yuqiong Zhong, Rui Liu, Xiaomin Wang & Jessica Hahne - 2022 - BMC Medical Ethics 23 (1):1-9.
    BackgroundLittle previous research has been conducted outside of major cities in China to examine how physicians currently perceive palliative care, and to identify specific goals for training as palliative care access expands. This study explored physicians’ perceptions of palliative care integration for advanced cancer patients in Changsha, China.MethodsWe conducted semi-structured qualitative interviews with physicians specializing in hematology or oncology at a tertiary hospital.ResultsMost physicians viewed palliative care as equivalent to end-of-life care, while a minority considered it possible to integrate palliative (...)
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  27. Trust and Digital Privacy in Healthcare: A Cross-Sectional Descriptive Study of Trust and Attitudes Towards Uses of Electronic Health Data Among the General Public in Sweden.Niels Lynøe, Gert Helgesson & Sara Belfrage - 2022 - BMC Medical Ethics 23 (1):1-8.
    BackgroundThe ability of healthcare to protect sensitive personal data in medical records and registers might influence public trust, which in turn might influence willingness to allow healthcare to use such data. The aim of this study was to examine how the general public’s trust relates to their attitudes towards uses of health data.MethodsA stratified sample from the general Swedish population received a questionnaire about their willingness to share health data. Respondents were also asked about their trust in the management and (...)
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  28. Ethical and Regulatory Implications of the COVID-19 Pandemic for the Medical Devices Industry and its Representatives.Guy Maddern, Bernadette Richards, Robyn Clay-Williams, Katrina Hutchison, Quinn Grundy, Jane Johnson, Wendy Rogers & Brette Blakely - 2022 - BMC Medical Ethics 23 (1):1-7.
    The development and deployment of medical devices, along with most areas of healthcare, has been significantly impacted by the COVID-19 pandemic. This has had variable ethical implications, two of which we will focus on here. First, medical device regulations have been rapidly amended to expedite approvals of devices ranging from face masks to ventilators. Although some regulators have issued cessation dates, there is inadequate discussion of triggers for exiting these crisis standards, and evidence that this may not be feasible. Given (...)
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  29.  2
    What Ethical Approaches Are Used by Scientists When Sharing Health Data? An Interview Study.Deborah Mascalzoni, Heidi Beate Bentzen & Jennifer Viberg Johansson - 2022 - BMC Medical Ethics 23 (1).
    BackgroundHealth data-driven activities have become central in diverse fields, and new ethical challenges have arisen with regards to privacy, integrity, and appropriateness of use. To ensure the protection of individuals’ fundamental rights and freedoms in a changing environment, including their right to the protection of personal data, we aim to identify the ethical approaches adopted by scientists during intensive data exploitation when collecting, using, or sharing peoples’ health data.MethodsTwelve scientists who were collecting, using, or sharing health data in different contexts (...)
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  30. Who’s Afraid of Genetic Tests?: An Assessment of Singapore’s Public Attitudes and Changes in Attitudes After Taking a Genetic Test.Ian McGonigle, Hie Lim Kim, Manoj Vimal, Shreshtha Jolly & Ross Cheung - 2022 - BMC Medical Ethics 23 (1):1-8.
    BackgroundAs a consequence of precision medicine initiatives, genomic technologies have rapidly spread around the world, raising questions about genetic privacy and the ethics of data sharing. Previous scholarship in bioethics and science and technology studies has made clear that different nations have varying expectations about trust, transparency, and public reason in relation to emerging technologies and their governance. The key aims of this article are to assess genetic literacy, perceptions of genetic testing, privacy concerns, and governing norms amongst the Singapore (...)
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  31. Participatory Development of CURA, a Clinical Ethics Support Instrument for Palliative Care.Suzanne Metselaar, Guy Widdershoven, H. Roeline Pasman & Malene Vera van Schaik - 2022 - BMC Medical Ethics 23 (1):1-12.
    BackgroundExisting clinical ethics support instruments are considered useful. However, users report obstacles in using them in daily practice. Including end users and other stakeholders in developing CES instruments might help to overcome these limitations. This study describes the development process of a new ethics support instrument called CURA, a low-threshold four-step instrument focused on nurses and nurse assistants working in palliative care. MethodWe used a participatory development design. We worked together with stakeholders in a Community of Practice throughout the study. (...)
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  32.  1
    Operationalising a Real-Time Research Ethics Approach: Supporting Ethical Mindfulness in Agriculture-Nutrition-Health Research in Malawi.Joseph Mfutso-Bengo, Edward Joy, Eric Umar, Kate Millar & Limbanazo Matandika - 2022 - BMC Medical Ethics 23 (1):1-17.
    BackgroundThere have been notable investments in large multi-partner research programmes across the agriculture-nutrition-health nexus. These studies often involve human participants and commonly require research ethics review. These ANH studies are complex and can raise ethical issues that need pre-field work, ethical oversight and also need an embedded process that can identify, characterise and manage ethical issues as the research work develops, as such more embedded and dynamic ethics processes are needed. This work builds on notions of ‘ethics in practice’ by (...)
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  33. The Role of Community Advisory Boards in Community-Based HIV Clinical Trials: A Qualitative Study From Tanzania.Blandina T. Mmbaga, Eligius Lyamuya, Emmanuel Balandya, Nathanael Sirili, Bruno F. Sunguya & Godwin Pancras - 2022 - BMC Medical Ethics 23 (1):1-10.
    BackgroundCommunity Advisory Boards have become essential organs of involving communities in HIV clinical trials especially in developing countries. However, limited empirical evidence exists on the role of CABs in low and middle-income countries including Tanzania. This study aims at exploring the role of CABs in community-based HIV clinical trials conducted in Tanzania.MethodologyWe adopted a phenomenological approach to purposefully select HIV clinical trial stakeholders. These included CAB members, researchers and Institutional Review Board members in Tanzania. We conducted In-depth Interviews with ten (...)
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  34. Conceptualizing the Impact of Moral Case Deliberation: A Multiple-Case Study in a Health Care Institution for People with Intellectual Disabilities.A. C. Molewijk, J. L. P. van Gurp & J. C. de Snoo-Trimp - 2022 - BMC Medical Ethics 23 (1):1-15.
    BackgroundAs moral case deliberations have increasingly been implemented in health care institutions as a form of ethics support, it is relevant to know whether and how MCDs actually contribute to positive changes in care. Insight is needed on what actually happens in daily care practice following MCD sessions. This study aimed at investigating the impact of MCD and exploring how ‘impact of MCD’ should be conceptualized for future research.MethodsA multiple-case study was conducted in a care organization for people with intellectual (...)
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  35.  1
    Development and Validation of an Instrument to Measure Pediatric Nurses' Adherence to Ethical Codes.Mahboube Moradi Cherati, Naeimeh Sarkhani, Reza Negarandeh, Lida Nikfarid & Raziyeh Beykmirza - 2022 - BMC Medical Ethics 23 (1):1-8.
    Background and aimThe nature of pediatric settings may encounter nurses with more complicated ethical issues. A code of ethics guides nurses to act and decide ethically as a profession. Also, there is always a need to evaluate amount nurses adhere to this code of ethics, using valid and reliable instruments. This study aimed to develop a questionnaire and assess its psychometric properties to measure pediatric nurses' adherence to the code of ethics. MethodsIn this methodological research study, firstly, the questionnaire was (...)
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  36.  3
    Social Network-Based Ethical Analysis of COVID-19 Vaccine Supply Policy in Three Central Asian Countries.Kerim M. Munir, Totugul Murzabekova, Zhangir Tulekov, Damin Asadov, Daniel Wikler & Timur Aripov - 2022 - BMC Medical Ethics 23 (1):1-8.
    BackgroundIn the pandemic time, many low- and middle-income countries are experiencing restricted access to COVID-19 vaccines. Access to imported vaccines or ways to produce them locally became the principal source of hope for these countries. But developing a strategy for success in obtaining and allocating vaccines was not easy task. The governments in those countries have faced the difficult decision whether to accept or reject offers of vaccine diplomacy, weighing the price and availability of COVID-19 vaccines against the concerns over (...)
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  37.  1
    ‘I Feel That Injustice is Being Done to Me’: A Qualitative Study of Women’s Viewpoints on the (Lack of) Reimbursement for Social Egg Freezing.Veerle Provoost, Julie Nekkebroeck, Gily Coene & Michiel De Proost - 2022 - BMC Medical Ethics 23 (1).
    BackgroundDuring the last decade, the possibility for women to cryopreserve oocytes in anticipation of age-related fertility loss, also referred to as social egg freezing, has become an established practice at fertility clinics around the globe. In Europe, there is extensive variation in the costs for this procedure, with the common denominator that there are almost no funding arrangements or reimbursement policies. This is the first qualitative study that specifically explores viewpoints on the reimbursement for women who had considered to uptake (...)
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  38. Consent to Organ Offers From Public Health Service “Increased Risk” Donors Decreases Time to Transplant and Waitlist Mortality.John P. Roberts, Chiung-Yu Huang, Amy M. Shui, Mehdi Tavakol, Arya Zarinsefat & Yvonne M. Kelly - 2022 - BMC Medical Ethics 23 (1):1-9.
    BackgroundThe Public Health Service Increased Risk designation identified organ donors at increased risk of transmitting hepatitis B, hepatitis C, and human immunodeficiency virus. Despite clear data demonstrating a low absolute risk of disease transmission from these donors, patients are hesitant to consent to receiving organs from these donors. We hypothesize that patients who consent to receiving offers from these donors have decreased time to transplant and decreased waitlist mortality.MethodsWe performed a single-center retrospective review of all-comers waitlisted for liver transplant from (...)
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  39. Participant Recall and Understandings of Information on Biobanking and Future Genomic Research: Experiences From a Multi-Disease Community-Based Health Screening and Biobank Platform in Rural South Africa.Janet Seeley, Emily B. Wong, Mark J. Siedner, Olivier Koole, Dickman Gareta, Resign Gunda, Dumsani Gumede, Nothando Ngwenya & Manono Luthuli - 2022 - BMC Medical Ethics 23 (1).
    BackgroundLimited research has been conducted on explanations and understandings of biobanking for future genomic research in African contexts with low literacy and limited healthcare access. We report on the findings of a sub-study on participant understanding embedded in a multi-disease community health screening and biobank platform study known as ‘Vukuzazi’ in rural KwaZulu-Natal, South Africa.MethodsSemi-structured interviews were conducted with research participants who had been invited to take part in the Vukuzazi study, including both participants and non-participants, and research staff that (...)
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  40. Collection and Use of Human Materials During TB Clinical Research; a Review of Practices.Nelson Sewankambo, Betty Kwagala & Joseph Ochieng - 2022 - BMC Medical Ethics 23 (1).
    BackgroundHuman biological materials are usually stored for possible future use in research because they preserve valuable biological information, save time and resources, which would have been spent on collection of fresh samples. However, use of these materials may pose ethical challenges such as unauthorized disclosure of genetic information, which can result in dire consequences for individuals or communities including discrimination, stigma, and psychological harm; has biosecurity implications; and loss of control or ownership of samples or data. To understand these problems (...)
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  41. Future Healthcare Providers and Professionalism on Social Media: A Cross-Sectional Study.Issam Shaarani, Adam Saab, Louna Ftouni, Ibrahim Hasan & Rabih Soubra - 2022 - BMC Medical Ethics 23 (1):1-9.
    BackgroundNowadays, social media have become central in the daily lives of people, including healthcare professionals. Fears arise that the accelerated growth of these social platforms was not accompanied by the appropriate training of the healthcare students and workers on the professional use of social media. This study primarily aimed to assess the awareness of the healthcare students at Beirut Arab University, Lebanon on the professional standards of social media. It also aimed to assess the presence of differences in the practices (...)
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  42. Ethical and Practical Considerations for Cell and Gene Therapy Toward an HIV Cure: Findings From a Qualitative in-Depth Interview Study in the United States.Jane Simoni, Steven G. Deeks, Michael J. Peluso, John A. Sauceda, Boro Dropulić, Kim Anthony-Gonda, Jen Adair, Jeff Taylor, Lynda Dee, Jeff Sheehy, Laurie Sylla, Michael Louella, Hursch Patel, John Kanazawa & Karine Dubé - 2022 - BMC Medical Ethics 23 (1).
    BackgroundHIV cure research involving cell and gene therapy has intensified in recent years. There is a growing need to identify ethical standards and safeguards to ensure cell and gene therapy HIV cure research remains valued and acceptable to as many stakeholders as possible as it advances on a global scale.MethodsTo elicit preliminary ethical and practical considerations to guide CGT HIV cure research, we implemented a qualitative, in-depth interview study with three key stakeholder groups in the United States: biomedical HIV cure (...)
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  43.  4
    Which Features of Patients Are Morally Relevant in Ventilator Triage? A Survey of the UK Public.Walter Sinnott-Armstrong, Hazem Zohny, Julian Savulescu, Dominic Wilkinson, Vincent Conitzer, Jana Schaich Borg & Lok Chan - 2022 - BMC Medical Ethics 23 (1):1-14.
    BackgroundIn the early stages of the COVID-19 pandemic, many health systems, including those in the UK, developed triage guidelines to manage severe shortages of ventilators. At present, there is an insufficient understanding of how the public views these guidelines, and little evidence on which features of a patient the public believe should and should not be considered in ventilator triage.MethodsTwo surveys were conducted with representative UK samples. In the first survey, 525 participants were asked in an open-ended format to provide (...)
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  44. Travelling to Die: Views, Attitudes and End-of-Life Preferences of Israeli Considering Receiving Aid-in-Dying in Switzerland.Daniel Sperling - 2022 - BMC Medical Ethics 23 (1).
    BackgroundFollowing the increased presence of the Right-to-Die Movement, improved end-of-life options, and the political and legal status of aid-in-dying around the globe, suicide tourism has become a promising alternative for individuals who wish to end their lives. Yet, little is known about this from the perspective of those who engage in the phenomenon.MethodsThis study applied the qualitative research approach, following the grounded theory tradition. It includes 11 in-depth semi-structured interviews with Israeli members of the Swiss non-profit Dignitas who contemplated traveling (...)
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  45. “Many Roads Lead to Rome and the Artificial Intelligence Only Shows Me One Road”: An Interview Study on Physician Attitudes Regarding the Implementation of Computerised Clinical Decision Support Systems.Sigrid Sterckx, Tamara Leune, Johan Decruyenaere, Wim Van Biesen & Daan Van Cauwenberge - 2022 - BMC Medical Ethics 23 (1).
    Research regarding the drivers of acceptance of clinical decision support systems by physicians is still rather limited. The literature that does exist, however, tends to focus on problems regarding the user-friendliness of CDSS. We have performed a thematic analysis of 24 interviews with physicians concerning specific clinical case vignettes, in order to explore their underlying opinions and attitudes regarding the introduction of CDSS in clinical practice, to allow a more in-depth analysis of factors underlying acceptance of CDSS. We identified three (...)
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  46. Pursuing Impact in Research: Towards an Ethical Approach.Inger Lise Teig, Michael Dunn, Angeliki Kerasidou & Kristine Bærøe - 2022 - BMC Medical Ethics 23 (1).
    BackgroundResearch proactively and deliberately aims to bring about specific changes to how societies function and individual lives fare. However, in the ever-expanding field of ethical regulations and guidance for researchers, one ethical consideration seems to have passed under the radar: How should researchers act when pursuing actual, societal changes based on their academic work?Main textWhen researchers engage in the process of bringing about societal impact to tackle local or global challenges important concerns arise: cultural, social and political values and institutions (...)
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  47.  1
    Qualitative Inquiry Into Adolescents’ Experience of Ethical Challenges During Enrollment and Adherence to Antiretroviral Therapy (ART) in Temeke Regional Referral Hospital, Tanzania.Connie M. Ulrich, Gasto Frumence, Gladys Reuben Mahiti & Renatha Sillo Joseph - 2022 - BMC Medical Ethics 23 (1):1-9.
    BackgroundAdolescents living with human immunodeficiency virus experience challenges, including lack of involvement in their care as well nondisclosure of HIV status, which leads to poor adherence to antiretroviral therapy. Parents have authority over their children, but during adolescence there is an increasing desire for independence. The aim of the study was to explore adolescents’ experience of challenges identified by adolescents ages 10–19 years attending HIV care and treatment at Temeke Regional Referral Hospital in Tanzania. MethodsAn exploratory descriptive qualitative design was (...)
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  48. Asking the Right Questions: Towards a Person-Centered Conception of Shared Decision-Making Regarding Treatment of Advanced Chronic Kidney Disease in Older Patients.Johannes J. M. van Delden, Willem Jan W. Bos, Anne M. Stiggelbout & Wouter R. Verberne - 2022 - BMC Medical Ethics 23 (1).
    An increasing number of older patients have to decide on a treatment plan for advanced chronic kidney disease, involving dialysis or conservative care. Shared decision-making is recommended as the model for decision-making in such preference-sensitive decisions. The aim of SDM is to come to decisions that are consistent with the patient’s values and preferences and made by the patient and healthcare professional working together. In clinical practice, however, SDM appears to be not yet routine and needs further implementation. A shift (...)
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  49. Combining Rules and Dialogue: Exploring Stakeholder Perspectives on Preventing Sexual Boundary Violations in Mental Health and Disability Care Organizations.Jan-Willem Weenink, Roland Bal, Guy Widdershoven, Eva van Baarle & Charlotte Kröger - 2022 - BMC Medical Ethics 23 (1).
    BackgroundSexual boundary violations in healthcare are harmful and exploitative sexual transgressions in the professional–client relationship. Persons with mental health issues or intellectual disabilities, especially those living in residential settings, are especially vulnerable to SBV because they often receive long-term intimate care. Promoting good sexual health and preventing SBV in these care contexts is a moral and practical challenge for healthcare organizations.MethodsWe carried out a qualitative interview study with 16 Dutch policy advisors, regulators, healthcare professionals and other relevant experts to explore (...)
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  50. Gender Differences in Response to Medical Red Packets (Hongbao, Monetary Gifts): A Questionnaire Study on Young Doctors in China.Hanhui Xu & Mengci Yuan - 2022 - BMC Medical Ethics 23 (1).
    BackgroundThe acceptance of informal payments by doctors is usually viewed as unethical behavior. However, in China, such behavior is a common practice. In this study, we focus on the gender differences in accepting red packets by young doctors in China.MethodsA total of 413 young doctors were selected for the study, all of whom were grouped by gender. The questionnaire was designed to include general demographic characteristics, whether they had ever been offered red packets, whether they had ever accepted red packets, (...)
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  51. Ethical Decision-Making Climate, Moral Distress, and Intention to Leave Among ICU Professionals in a Tertiary Academic Hospital Center.Michele Zimmer, Julie Landon, Samantha Dove, Kerri Bouchard, Eunsung Cho, Melissa Davis-Gilbert, Rachel Hausladen, Karen McQuillan, Ali Tabatabai, Trishna Mukherjee, Raya Kheirbek, Samuel Tisherman, Tracey Wilson & Henry Silverman - 2022 - BMC Medical Ethics 23 (1).
    BackgroundCommentators believe that the ethical decision-making climate is instrumental in enhancing interprofessional collaboration in intensive care units. Our aim was twofold: to determine the perception of the ethical climate, levels of moral distress, and intention to leave one's job among nurses and physicians, and between the different ICU types and determine the association between the ethical climate, moral distress, and intention to leave.MethodsWe performed a cross-sectional questionnaire study between May 2021 and August 2021 involving 206 nurses and physicians in a (...)
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