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  1. Clinical Ethics Consultations: A Scoping Review of Reported Outcomes.Ann M. Heesters, Ruby R. Shanker, Kevin Rodrigues, Daniel Z. Buchman, Andria Bianchi, Claudia Barned, Erica Nekolaichuk, Eryn Tong, Marina Salis & Jennifer A. H. Bell - 2022 - BMC Medical Ethics 23 (1).
    BackgroundClinical ethics consultations can be complex interventions, involving multiple methods, stakeholders, and competing ethical values. Despite longstanding calls for rigorous evaluation in the field, progress has been limited. The Medical Research Council proposed guidelines for evaluating the effectiveness of complex interventions. The evaluation of CEC may benefit from application of the MRC framework to advance the transparency and methodological rigor of this field. A first step is to understand the outcomes measured in evaluations of CEC in healthcare settings. ObjectiveThe primary (...)
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  • Evaluating the Effectiveness of Clinical Ethics Committees: A Systematic Review.Chiara Crico, Virginia Sanchini, Paolo Giovanni Casali & Gabriella Pravettoni - 2021 - Medicine, Health Care and Philosophy 24 (1):135-151.
    Clinical Ethics Committees, as distinct from Research Ethics Committees, were originally established with the aim of supporting healthcare professionals in managing controversial clinical ethical issues. However, it is still unclear whether they manage to accomplish this task and what is their impact on clinical practice. This systematic review aims to collect available assessments of CECs’ performance as reported in literature, in order to evaluate CECs’ effectiveness. We retrieved all literature published up to November 2019 in six databases, following PRISMA guidelines. (...)
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  • Evaluating Assessment Tools of the Quality of Clinical Ethics Consultations: A Systematic Scoping Review From 1992 to 2019.Nicholas Yue Shuen Yoon, Yun Ting Ong, Hong Wei Yap, Kuang Teck Tay, Elijah Gin Lim, Clarissa Wei Shuen Cheong, Wei Qiang Lim, Annelissa Mien Chew Chin, Ying Pin Toh, Min Chiam, Stephen Mason & Lalit Kumar Radha Krishna - 2020 - BMC Medical Ethics 21 (1):1-11.
    BackgroundAmidst expanding roles in education and policy making, questions have been raised about the ability of Clinical Ethics Committees s to carry out effective ethics consultations. However recent reviews of CECs suggest that there is no uniformity to CECons and no effective means of assessing the quality of CECons. To address this gap a systematic scoping review of prevailing tools used to assess CECons was performed to foreground and guide the design of a tool to evaluate the quality of CECons.MethodsGuided (...)
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  • Capacity of Community Advisory Boards for Effective Engagement in Clinical Research: A Mixed Methods Study.Joseph Ochieng, Winfred Badanga Nazziwa, Irene Seryazi Semakula, Fedress Kaliba, Collins Agaba, Mastula Nanfuka, Andrew Mijumbi & Levicatus Mugenyi - 2021 - BMC Medical Ethics 22 (1):1-7.
    BackgroundCommunity engagement is a key component in health research. One of the ways health researchers ensure community engagement is through Community Advisory Boards. The capacity of CABs to properly perform their role in clinical research has not been well described in many resource limited settings. In this study, we assessed the capacity of CABs for effective community engagement in Uganda.MethodsWe conducted a cross sectional study with mixed methods. We used structured questionnaires and key informant interviews to collect data from CAB (...)
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  • Hospital Ethics Committees in accredited hospitals in Poland—availability of information.Patrycja Zurzycka, Grażyna Puto, Katarzyna Czyżowicz & Iwona Repka - 2022 - International Journal of Ethics Education 7 (1):73-85.
    The role of Hospital Ethics Committees is to support patients and their relatives as well as medical staff in solving ethical issues that arise in relation to the implementation of medical care. In Poland there are no clearly formulated legal regulations concerning the establishment and functioning of hospital ethics committees. Hospitals applying for accreditation are obliged to present solutions defining the way of solving ethical issues in a given institution, some of them appoint HECs for this purpose. The aim of (...)
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  • Framework for Evaluation Research on Clinical Ethical Case Interventions: The Role of Ethics Consultants.Joschka Haltaufderheide, Stephan Nadolny, Jochen Vollmann & Jan Schildmann - 2022 - Journal of Medical Ethics 48 (6):401-406.
    Evaluation of clinical ethical case consultations has been discussed as an important research task in recent decades. A rigid framework of evaluation is essential to improve quality of consultations and, thus, quality of patient care. Different approaches to evaluate those services appropriately and to determine adequate empirical endpoints have been proposed. A key challenge is to provide an answer to the question as to which empirical endpoints—and for what reasons—should be considered when evaluating the quality of a service. In this (...)
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  • Morisprudence: A Theoretical Framework for Studying the Relationship Linking Moral Case Deliberation, Organisational Learning and Quality Improvement.Niek Kok, Marieke Zegers, Hans van der Hoeven, Cornelia Hoedemaekers & Jelle van Gurp - forthcoming - Journal of Medical Ethics:medethics-2021-107943.
    There is a claim that clinical ethics support services improve healthcare quality within healthcare organisations. However, there is lack of strong evidence supporting this claim. Rather, the current focus is on the quality of CESS themselves or on individual learning outcomes. In response, this article proposes a theoretical framework leading to empirical hypotheses that describe the relationship between a specific type of CESS, moral case deliberation and the quality of care at the organisational level. We combine insights from the literature (...)
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  • Ethics Consultation in U.S. Hospitals: A National Follow-Up Study.Ellen Fox, Marion Danis, Anita J. Tarzian & Christopher C. Duke - 2021 - American Journal of Bioethics 22 (4):5-18.
    A 1999–2000 national study of U.S. hospitals raised concerns about ethics consultation practices and catalyzed improvement efforts. To assess how practices have changed since 2000, we administ...
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  • Male or Female Genital Cutting: Why ‘Health Benefits’ Are Morally Irrelevant.Brian D. Earp - 2021 - Journal of Medical Ethics 47 (12):92-92.
    The WHO, American Academy of Pediatrics and other Western medical bodies currently maintain that all medically unnecessary female genital cutting of minors is categorically a human rights violation, while either tolerating or actively endorsing medically unnecessary male genital cutting of minors, especially in the form of penile circumcision. Given that some forms of female genital cutting, such as ritual pricking or nicking of the clitoral hood, are less severe than penile circumcision, yet are often performed within the same families for (...)
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  • Clinical Ethics Needs Assessment: Adapting Clinical Ethics to a Population Health Program.Etan Kuperberg - 2020 - HEC Forum 32 (1):21-32.
    The clinical encounter between providers and patients is insufficient: most factors influencing health outcomes occur outside the clinic. Community Health Needs Assessments address this insufficiency via collaboration between hospitals and the communities they serve to address systemic sociological-economic variables impacting health outcomes. Considering this, why are Health Care Ethics Consultation services limited to the clinical setting? We can cultivate better ethics outcomes by addressing systemic sociological-economic factors that cause recurring ethics issues in the hospital. In this article, I argue for (...)
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  • Trust and the Ethical Challenges in the Use of Whole Genome Sequencing for Tuberculosis Surveillance: A Qualitative Study of Stakeholder Perspectives.Carly Jackson, Jennifer L. Gardy, Hedieh C. Shadiloo & Diego S. Silva - 2019 - BMC Medical Ethics 20 (1):43.
    Emerging genomic technologies promise more efficient infectious disease control. Whole genome sequencing is increasingly being used in tuberculosis diagnosis, surveillance, and epidemiology. However, while the use of WGS by public health agencies may raise ethical, legal, and socio-political concerns, these challenges are poorly understood. Between November 2017 and April 2018, we conducted semi-structured interviews with 22 key stakeholders across the fields of governance and policy, public health, and laboratory sciences representing the major jurisdictions currently using WGS in national TB programs. (...)
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  • Shall Parent / Patient Wishes Be Fulfilled in Any Case? A Series of 32 Ethics Consultations: From Reproductive Medicine to Neonatology.Mirella Muggli, Christian De Geyter & Stella Reiter-Theil - 2019 - BMC Medical Ethics 20 (1):4.
    Questions concerning the parent/ patient’s autonomy are seen as one of the most important reasons for requesting Ethics Consultations. Respecting parent/ patient’s autonomy also means respecting the patient’s wishes. But those wishes may be controversial and sometimes even go beyond legal requirements. The objective of this case series of 32 ECs was to illustrate ethically challenging parent / patients’ wishes during the first stages of life and how the principle of patient’s autonomy was handled. The case series has a qualitative (...)
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  • Do We Understand the Intervention? What Complex Intervention Research Can Teach Us for the Evaluation of Clinical Ethics Support Services.Jan Schildmann, Stephan Nadolny, Joschka Haltaufderheide, Marjolein Gysels, Jochen Vollmann & Claudia Bausewein - 2019 - BMC Medical Ethics 20 (1):48.
    Evaluating clinical ethics support services has been hailed as important research task. At the same time, there is considerable debate about how to evaluate CESS appropriately. The criticism, which has been aired, refers to normative as well as empirical aspects of evaluating CESS. In this paper, we argue that a first necessary step for progress is to better understand the intervention in CESS. Tools of complex intervention research methodology may provide relevant means in this respect. In a first step, we (...)
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  • Values, Quality, and Evaluation in Ethics Consultation.Lucia D. Wocial, Elizabeth Molnar & Mary A. Ott - 2016 - Ajob Empirical Bioethics 7 (4):227-234.