30 found

Year:

  1. Living Bioethics, Clinical Ethics Committees and Children's Consent to Heart Surgery.Priscilla Alderson, Deborah Bowman, Joe Brierley, Martin J. Elliott, Romana Kazmi, Rosa Mendizabal-Espinosa, Jonathan Montgomery, Katy Sutcliffe & Hugo Wellesley - 2022 - Clinical Ethics 17 (3):272-281.
    This discussion paper considers how seldom recognised theories influence clinical ethics committees. A companion paper examined four major theories in social science: positivism, interpretivism, critical theory and functionalism, which can encourage legalistic ethics theories or practical living bioethics, which aims for theory–practice congruence. This paper develops the legalistic or living bioethics themes by relating the four theories to clinical ethics committee members’ reported aims and practices and approaches towards efficiency, power, intimidation, justice, equality and children’s interests and rights. Different approaches (...)
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  2.  1
    Should Medical Students Perform Pelvic Exams on Anaesthetised Patients Without Explicit Consent?Chloe Bell & Nathan Emmerich - 2022 - Clinical Ethics 17 (3):230-234.
    There have been many reports of medical students performing pelvic exams on anaesthetised patients without the necessary consent being provided or even sought. These cases have led to an ongoing discussion regarding the need to ensure informed consent has been secured and furthermore, how it might be best obtained. We consider the importance of informed consent, the potential harm to both the patient and medical student risked by the suboptimal consent process, as well as alternatives to teaching pelvic examinations within (...)
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  3.  1
    Gene Therapy and Editing in the Treatment of Hereditary Blood Disorders: Medical and Ethical Aspects.Paula Cano Alburquerque, Lucía Gómez-Tatay & Justo Aznar - 2022 - Clinical Ethics 17 (3):315-325.
    Gene therapy and gene editing are revolutionising the treatment of genetic diseases, most notably haematological disorders. This paper evaluates the use of both techniques in hereditary blood disorders. Many studies have been conducted in this field, especially with gene therapy, with very promising results in diseases such as haemophilia, certain haemoglobinopathies and Fanconi anaemia. The application of these techniques in clinical practice and the foreseeable development of these approaches in the coming years suggest that it might be useful to evaluate (...)
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  4. The Relationship Between Workload and Adherence to Professional Codes of Ethics Among a Sample of Iranian Nurses.Mahsa Dadkhah-Tehrani & Mohsen Adib-Hajbaghery - 2022 - Clinical Ethics 17 (3):290-296.
    Background Many studies have investigated the adherence to professional codes of ethics by nurses. However, no study has explicitly examined the relationship between workload and adherence to professional codes of ethics among Iranian nurses. Objective This study aimed to explore the relationships between workload and adherence to professional codes of ethics among a sample of Iranian nurses. Materials and Methods A cross-sectional descriptive study was conducted on 213 nurses who were randomly selected from the different wards of Shahid Beheshti Hospital (...)
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  5.  4
    Ethical Leadership, Psychological Empowerment and Caring Behavior From the Nurses’ Perspective.Mojtaba Dehghani-Tafti, Maasoumeh Barkhordari-Sharifabad, Khadijeh Nasiriani & Hossein Fallahzadeh - 2022 - Clinical Ethics 17 (3):248-255.
    Background Care is the basis of the nursing profession and nurse’s caring behavior is one of the important factors in patient satisfaction. On the other hand, psychological empowerment can improve the provision of care services, and leaders have a significant impact on the behavior of followers. This study determined the correlation between ethical leadership, psychological empowerment, and caring behavior from nurses’ perspective. Methods This cross-sectional descriptive study was conducted in 2019. A total of 200 nurses were selected by stratified random (...)
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  6.  1
    Moral Distress in Nurses: Resources and Constraints, Consequences, and Interventions.Mohammad Javad Ghazanfari, Amir Emami Zeydi, Reza Panahi, Reza Ghanbari, Fateme Jafaraghaee, Hamed Mortazavi & Samad Karkhah - 2022 - Clinical Ethics 17 (3):265-271.
    Background Moral distress is a complex and challenging issue in the nursing profession that can negatively affect the nurses’ job satisfaction and retention and the quality of patient care. This study focused on describing the resources and constraints, consequences, and interventions of moral distress in nurses. Methods In a literature review, an extensive electronic search was conducted in databases including PubMed, ISI, Scopus as well as Google Scholar search engine using the keywords including “moral distress” and “nurses” to identify resources, (...)
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  7.  1
    Intimate Partner Violence in Pakistan: Ethical Implications in an Emergency Case.Anum Khan, Fahad Ahmed, Müge Demir & Önder İlgili - 2022 - Clinical Ethics 17 (3):311-314.
    In developing countries, the patriarchal social construct, unsatisfactory legal protection, and underlying cultural bias against women have resulted in increasing intimate partner violence, which largely goes unaddressed, undocumented, and unreported in healthcare settings. This case study presents a common scenario of intimate partner violence and carefully analyzes its ethical implications in an emergency case at a tertiary care hospital in Karachi, Pakistan. In this study, basic ethical principles are used to discuss important ethical challenges faced daily by healthcare workers in (...)
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  8. A New Era for Clinical Ethics.Jonathan Lewis - 2022 - Clinical Ethics 17 (3):221-224.
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  9.  1
    Clinical Genomics in the 21st Century: The Fine Balance Between Ethics and Science.Terence Y. S. Liew & Chun Y. Khoo - 2022 - Clinical Ethics 17 (3):282-285.
    The 21st century has been revolutionary for the field of clinical genomics, with major advancements and breakthroughs over the years. It is now considered an instrumental tool in clinical and preventive medicine and has been used on a day-to-day basis to complement current clinical practice. However, with advancements in genomics comes greater bioethical concerns, which becomes increasingly complex with more cutting-edge technology. Some of the major ethical concerns include obtaining informed consent, possibility for genetic enhancements and eugenics, genomic equity and (...)
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  10. Ethical Concerns in Maternal and Child Healthcare in Malawi.Gladys Msiska, Tiwonge Munkhondya, Berlington Munkhondya, Lucy Ngoma, Hlalapi Kunkeyani, Andrew Simwaka, Pam Smith, Lucy Kululanga, Rodwell Gundo, Ezereth Kabuluzi, Patrick Mapulanga & Chisomo Mulenga - 2022 - Clinical Ethics 17 (3):256-264.
    Background Caring is a core function of nurses and it confers upon them ethical obligations as ethical agents. Failure to carry out such ethical obligations raises ethical concerns. This study was not intended to explore ethical concerns, but the reported findings reveal problems which have ethical implications. This paper aims to elucidate the ethical issues inherent in the findings and propose strategies to mitigate them. Research design and methods An exploratory-descriptive qualitative design was used within a larger Action Research Study. (...)
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  11. Colombian People's Positions Regarding Physician-Assisted Suicide.Claudia Pineda Marín, Lina Franco Sierra, Paul Clay Sorum & Etienne Mullet - 2022 - Clinical Ethics 17 (3):286-289.
    The views on the acceptability of physician-assisted suicide of lay people in a Latin American country, Colombia, have been examined. In July 2019–January 2020, 134 lay people in Bogota judged the acceptability of physician-assisted suicide in 48 realistic scenarios composed of all combinations of four factors: the patient's age, the level of incurability of the illness, the type of suffering, and the patient's request for physician-assisted suicide. In all scenarios, the patients were women receiving the best possible care. The ratings (...)
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  12.  4
    Bell V Tavistock: Rethinking Informed Decision-Making as the Practical Device of Consent for Medical Treatment.Abeezar I. Sarela - 2022 - Clinical Ethics 17 (3):241-247.
    The decision of the High Court in Bell v Tavistock has excited considerable discussion about lawful consent for puberty-blocking drug treatment for children with gender dysphoria. The present paper draws attention to a wider question that surfaces through this case: is informed decision-making an adequate practical tool for seeking and obtaining patients’ consent for medical treatment? Informed decision-making engages the premises of the rational choice theory: that people will have well-crystallised health goals; and, if they are provided with sufficient information (...)
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  13. Is There a Right to a Fully Vaccinated Care Team?Jordan L. Schwartzberg, Jeremy Levenson & Jacob M. Appel - 2022 - Clinical Ethics 17 (3):235-240.
    Although COVID-19 vaccines are free and readily available in the United States, many healthcare workers remain unvaccinated, potentially exposing their patients to a life-threatening pathogen. This paper reviews the ethical and legal factors surrounding patient requests to limit their care teams exclusively to vaccinated providers. Key factors that shape policy in this area include patient autonomy, the rights of healthcare workers, and the duties of healthcare institutions. Hospitals must also balance the rights of interested parties in the context of logistical (...)
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  14.  1
    An Observational Study on the Process of Collaborative Deliberation in Arranging Long-Term Care: The Perception of Clients and Professionals.Catharina M. van Leersum, Ben van Steenkiste, Judith R. L. M. Wolf, Trudy van der Weijden & Albine Moser - 2022 - Clinical Ethics 17 (3):297-310.
    Background Clients are invited to play a role in decisions about their care. Collaborative deliberation comprises constructive engagement, recognition of alternative actions, comparative learning, construction and elicitation of preferences and preference integration. Collaborative deliberation between clients and professionals is a process that requires an interest in each other, sharing of views on alternatives and preferences and integrating into decisions. The aim is to gain insight into collaborative deliberation in consultations and the clients’ perception of arranging long-term care. Design A descriptive (...)
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  15.  1
    Conscience Absolutism Via Legislative Amendment.Peter G. N. West-Oram & Jordanna A. A. Nunes - 2022 - Clinical Ethics 17 (3):225-229.
    On 30 June 2021, Ohio state Governor, Mike DeWine, signed a Bill which would enact the state's budget for the next two years. In addition to its core funding imperatives, the Bill also contained an amendment significantly expanding entitlements of health care providers to conscientiously object to professional duties to provide controversial health care services. This amendment has been heavily criticised as providing the means to allow health care providers to discriminate against a wide range of persons by denying them (...)
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  16.  5
    Workplace Silence Behavior and its Consequences on Nurses: A New Egyptian Validation Scale of Nursing Motives.Nagah Abd El-Fattah Mohamed Aly, Safaa M. El-Shanawany & Maha Ghanem - 2022 - Clinical Ethics 17 (1):71-82.
    Background Workplace silence behavior is a social collective phenomenon. It refers to nurses choosing to withhold their ideas, opinions and concerns about critical issues in their workplace. Workplace silence behavior poses a threat to organizational ethics and success. It also has adverse effects on the performance of nurses in health organizations. Underlying nursing causes of silence behaviors could be related to individual, social and organizational attributes in health care settings. Objectives The study aimed to develop a new Egyptian validation scale (...)
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  17.  2
    Physician Use of the Phrase “Due to Old Age” to Address Complaints of Elderly Symptoms in Japanese Medical Settings: The Merits and Drawbacks.Atsushi Asai, Taketoshi Okita, Masashi Tanaka, Seiji Bito & Motoki Ohnishi - 2022 - Clinical Ethics 17 (1):14-21.
    In everyday medical settings in Japan, physicians occasionally tell an elderly patient that their symptoms are “due to old age,” and there is some concern that patient care might be negatively impacted as a result. That said, as this phrase can have multiple connotations and meanings, there are certain instances in which the use of this phrase may not necessarily be indicative of ageism, or prejudice against the elderly. One of the goals in medical care is to address pain and (...)
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  18.  6
    Dementia, Beauty, and Play: A Way of Seeing and Being with the Wearisome Patient.Abram Brummett & Michelle Bach - 2022 - Clinical Ethics 17 (1):87-89.
    We describe a case of an elderly patient suffering from advanced dementia whose chronic confusion has become a source of frustration for her caregivers. Mrs. M experiences a touching interaction with a new nurse who takes a different approach with her. We describe this interaction and elaborate upon it by drawing from Catholic social teaching and the philosophy of play. Cases like these do not involve dramatic or esoteric ethical problematics, but rather the sort of dilemma born of the everyday (...)
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  19.  3
    How to Continue COVID-19 Vaccine Clinical Trials? The Ethics of Vaccine Research in a Time of Pandemic.Silvia Ceruti, Marco Cosentino & Mario Picozzi - 2022 - Clinical Ethics 17 (1):32-40.
    Between December 2020 and March 2021, the US Food and Drug Administration and the European Medicines Agency issued Emergency Use Authorizations and Conditional Marketing Authorizations for the distribution of the first COVID-19 vaccines. Although these vaccines were thoroughly assessed before their approval, regulators required companies to continue ongoing placebo-controlled clinical trials in order to gather further reliable scientific information on their safety and efficacy, as well as to start new studies to evaluate additional candidates. The aim of this paper is (...)
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  20.  7
    Ethical Dimensions in Randomized Trials and Off-Label Use of Investigational Drugs for COVID-19 Treatment.Pooja Dhupkar & Seema Mukherjee - 2022 - Clinical Ethics 17 (1):95-104.
    Coronavirus disease 2019 is a fast-developing viral pandemic spreading across the globe. Due to lack of availability of proven medicines against COVID-19, physicians have resorted to treatments through large trials of investigational drugs with poor evidence or those used for similar diseases. Large trials randomize 100–500+ patients at multiple hospitals in different countries to either receive these drugs or standard treatment. In order to expedite the process, some regulatory agencies had also given permission to use drugs approved for other diseases, (...)
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  21.  15
    A Taxonomy of Conscientious Objection in Healthcare.Nathan Gamble & Toni Saad - 2022 - Clinical Ethics 17 (1):63-70.
    Conscientious Objection has become a highly contested topic in the bioethics literature and public policy. However, when CO is discussed, it is almost universally referred to as a single entity. Reality reveals a more nuanced picture. Healthcare professionals may object to a given action on numerous grounds. They may oppose an action because of its ends, its means, or because of factors that lay outside of both ends and means. Our paper develops a taxonomy of CO, which makes it possible (...)
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  22.  1
    Bone Marrow Donation in Poland: 2021 Update, and the Impact of the Coronavirus Disease 2019 Pandemic on Haematopoietic Stem Cell Transplantation. [REVIEW]Aleksandra Janowiak-Majeranowska, Filip Lebiedziński & Alan Majeranowski - 2022 - Clinical Ethics 17 (1):22-31.
    Haematopoietic stem cell transplantation is a treatment modality that saves the health and lives of a growing number of patients around the world. In the majority of cases, the procedure is conducted to treat haematologic neoplasms, although it can also be used as a therapy for some non-haematooncological diseases. The progress that has been taking place in the field of haematopoietic stem cell transplantation involves the need for recruiting more and more potential unrelated bone marrow donors for allotransplantation. In Poland, (...)
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  23.  3
    Ethical Pause as a Framework for High-Value Care of Hospitalized COVID-19 Patients.Benjamin J. Martin, Margaret Plews-Ogan & Andrew S. Parsons - 2022 - Clinical Ethics 17 (1):1-4.
    Caring for hospitalized patients with COVID-19 raises ethical dilemmas in which clinicians must weigh the unknown value of an intervention against the unknown risk of viral transmission. Current guidelines for delivering high-value care in the time of the COVID-19 pandemic do not directly address ethical dilemmas that arise from the unique concerns of individual patients. We propose an “ethical pause” in which clinicians address ethical dilemmas by taking time to ask three questions that invoke the major bioethical principles of beneficence, (...)
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  24.  4
    Death, Taxes and Uncertainty: Economic Motivations in End-of-Life Decision Making.George Slade Mellgard & Jacob M. Appel - 2022 - Clinical Ethics 17 (1):90-94.
    Economic motivations are key drivers of human behavior. Unfortunately, they are largely overlooked in literature related to medical decisionmaking, particularly with regard to end-of-life care. It is widely understood that the directions of a proxy acting in bad faith can be overridden. But what of cases in which the proxy or surrogate appears to be acting in good faith to effectuate the patient’s values, yet doing so directly serves the decision-maker’s financial interests? Such situations are not uncommon. Many patients care (...)
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  25.  4
    Main Challenges in Adoption of Consultation Services of Hospital Ethics Committees: A Systematic Review of the Literature.Mir Sajjad Seyyed Mousavi, Rahim Khodayari-Zarnaq & Alireza Hajizadeh - 2022 - Clinical Ethics 17 (1):41-50.
    Background There are numerous challenges in the consultation services of the Hospital Ethics Committees that can impact the means of providing healthcare. This review aimed to identify the main challenges in the application of consultation services of the HEC and propose possible solutions. Methods This systematic review was conducted through searching electronic databases including PubMed, Scopus, Science Direct, ProQuest, and Embase. Inclusion criteria included studies published in English language in a peer-reviewed journal, from 2000 to 2019 were identified, which clearly (...)
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  26.  1
    Slow Motion Ethics: Narrative Responsibility in Clinical Care.Daryl Pullman - 2022 - Clinical Ethics 17 (1):105-109.
    Narrative theory is a dynamic and evolving field of inquiry that has made tremendous inroads in the medical humanities over the past 40 years. Numerous authors have popularized the idea that “thinking narratively” can produce important insights about the illness experience for physician and patient alike. This paper draws on aspects of narrative theory to emphasize the moral responsibilities that arise when we step into another person's life narrative, becoming a character in her or his story. This has especially significant (...)
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  27.  6
    Moral Sensitivity and Moral Distress Correlation in Nurses Caring of Patients with Spinal Cord Injury.Naser Sedghi Goyaghaj, Amir Zoka & Mohaddeseh Mohsenpour - 2022 - Clinical Ethics 17 (1):51-56.
    Background and aim Ethical sensitivity of nurses often plays an important role in their occupational commitment and moral decision-making. In some working conditions, nurses are affected by ethical distress and fail to pursue correct ethical actions despite having knowledge and a tendency for moral practice. Therefore, the present study aimed to investigate the correlation between sensitivity and ethical distress in the nurses of patients with spinal cord injuries. Materials and methods This descriptive-analytical study was performed on 160 of the nurses (...)
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  28.  7
    The Practice of Obtaining Informed Consent for Elective Surgery and Anesthesia From Patients’ Perspective: An Institutional Based Cross-Sectional Study.Tadese Tamire & Aragaw Tesfaw - 2022 - Clinical Ethics 17 (1):57-62.
    Introduction Informed consent is a body of shared decision-making process and voluntary authorization of patients to receive medical or surgical intervention. There are limited studies conducted so far to examine the practice of informed consent in Ethiopia. This study aimed to assess the practice of informed consent process for surgery and Anesthesia. Method A cross-sectional study was conducted from March to May 2019. The data were collected using interviewer-administered structured questionnaire and analyzed in SPSS version 23. Results A total of (...)
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  29.  2
    Confronting Medication Scarcity in the Era of COVID-19.Yoram Unguru - 2022 - Clinical Ethics 17 (1):83-86.
    Over the past decade, US patients and clinicians have endured medication shortages of nearly every class, including many lifesaving medications. These shortages have persisted despite determined efforts by federal, academic, and professional organizations. Medication shortages have resulted in lost lives, medication errors, and substantial financial cost. Economic drivers are the primary cause for drug shortages, exacerbated by manufacturing and quality problems, and unreliable and uncertain sources for many raw materials required to synthesize these drugs. Drug shortages force clinicians to make (...)
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  30.  1
    Administration of Pro Re Nata Medications by the Nurse to Incapacitated Patients: An Ethical Perspective.Mojtaba Vaismoradi, Cathrine Fredriksen Moe, M. Flores Vizcaya-Moreno & Piret Paal - 2022 - Clinical Ethics 17 (1):5-13.
    The administration of pro re nata medications is the responsibility of the nurse. However, ethical uncertainties often happen due to the inability of incapacitated patients to collaborate with the nurse in the process of decision making for pro re nata medication administration. There is a lack of integrative knowledge and insufficient understanding regarding ethical considerations surrounding the administration of pro re nata medications to incapacitated patients. Therefore, they have been discussed in this paper and practical strategies to avoid unethical practices (...)
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