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  1.  5
    Critical Appraisal of Advance Directives Given by Patients with Fatal Acute Stroke: An Observational Cohort Study.A. Alonso, D. Dörr & K. Szabo - 2017 - BMC Medical Ethics 18 (1):7.
    BackgroundAdvance directives imply the promise of determining future medical treatment in case of decisional incapacity. However, clinical practice increasingly indicates that standardized ADs often fail to support patients’ autonomy. To date, little data are available about the quality and impact of ADs on end-of-life decisions for incapacitated acute stroke patients.MethodsWe analyzed the ADs of patients with fatal stroke, focusing on: their availability and type, stated circumstances to which the AD should apply, and stated wishes regarding specific treatment options.ResultsBetween 2011 and (...)
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  2. The Intention to Disclose Medical Errors Among Doctors in a Referral Hospital in North Malaysia.H. S. Arvinder-Singh & Rashid Abdul - 2017 - BMC Medical Ethics 18 (1):3.
    BackgroundIn this study, medical errors are defined as unintentional patient harm caused by a doctor’s mistake. This topic, due to limited research, is poorly understood in Malaysia. The objective of this study was to determine the proportion of doctors intending to disclose medical errors, and their attitudes/perception pertaining to medical errors.MethodsThis cross-sectional study was conducted at a tertiary public hospital from July- December 2015 among 276 randomly selected doctors. Data was collected using a standardized and validated self-administered questionnaire intending to (...)
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  3. Donation After Brain Circulation Determination of Death.Anne L. Dalle Ave & James L. Bernat - 2017 - BMC Medical Ethics 18 (1):15.
    BackgroundThe fundamental determinant of death in donation after circulatory determination of death is the cessation of brain circulation and function. We therefore propose the term donation after brain circulation determination of death [DBCDD].ResultsIn DBCDD, death is determined when the cessation of circulatory function is permanent but before it is irreversible, consistent with medical standards of death determination outside the context of organ donation. Safeguards to prevent error include that: 1] the possibility of auto-resuscitation has elapsed; 2] no brain circulation may (...)
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  4. Presumed Consent: Licenses and Limits Inferred From the Case of Geriatric Hip Fractures.Joseph Bernstein, Drake LeBrun, Duncan MacCourt & Jaimo Ahn - 2017 - BMC Medical Ethics 18 (1):17.
    BackgroundHip fractures are common and serious injuries in the geriatric population. Obtaining informed consent for surgery in geriatric patients can be difficult due to the high prevalence of comorbid cognitive impairment. Given that virtually all patients with hip fractures eventually undergo surgery, and given that delays in surgery are associated with increased mortality, we argue that there are select instances in which it may be ethically permissible, and indeed clinically preferable, to initiate surgical treatment in cognitively impaired patients under the (...)
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  5.  2
    Dynamic Consent: A Potential Solution to Some of the Challenges of Modern Biomedical Research.Isabelle Budin-Ljøsne, Harriet J. A. Teare, Jane Kaye, Stephan Beck, Heidi Beate Bentzen, Luciana Caenazzo, Clive Collett, Flavio D’Abramo, Heike Felzmann, Teresa Finlay, Muhammad Kassim Javaid, Erica Jones, Višnja Katić, Amy Simpson & Deborah Mascalzoni - 2017 - BMC Medical Ethics 18 (1):4.
    BackgroundInnovations in technology have contributed to rapid changes in the way that modern biomedical research is carried out. Researchers are increasingly required to endorse adaptive and flexible approaches to accommodate these innovations and comply with ethical, legal and regulatory requirements. This paper explores how Dynamic Consent may provide solutions to address challenges encountered when researchers invite individuals to participate in research and follow them up over time in a continuously changing environment.MethodsAn interdisciplinary workshop jointly organised by the University of Oxford (...)
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  6.  1
    Ethical Framework for the Detection, Management and Communication of Incidental Findings in Imaging Studies, Building on an Interview Study of Researchers’ Practices and Perspectives.Eline M. Bunnik, Lisa van Bodegom, Wim Pinxten, Inez D. De Beaufort & Meike W. Vernooij - 2017 - BMC Medical Ethics 18 (1):10.
    BackgroundAs thousands of healthy research participants are being included in small and large imaging studies, it is essential that dilemmas raised by the detection of incidental findings are adequately handled. Current ethical guidance indicates that pathways for dealing with incidental findings should be in place, but does not specify what such pathways should look like. Building on an interview study of researchers’ practices and perspectives, we identified key considerations for the set-up of pathways for the detection, management and communication of (...)
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  7.  1
    Navigating Social and Ethical Challenges of Biobanking for Human Microbiome Research.H. Chuong Kim, M. Hwang David, Tullis D. Elizabeth, J. Waters Valerie, C. W. Yau Yvonne, S. Guttman David & C. O’Doherty Kieran - 2017 - BMC Medical Ethics 18 (1):1.
    BackgroundBiobanks are considered to be key infrastructures for research development and have generated a lot of debate about their ethical, legal and social implications. While the focus has been on human genomic research, rapid advances in human microbiome research further complicate the debate.DiscussionWe draw on two cystic fibrosis biobanks in Toronto, Canada, to illustrate our points. The biobanks have been established to facilitate sample and data sharing for research into the link between disease progression and microbial dynamics in the lungs (...)
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  8.  2
    Regulation of Genomic and Biobanking Research in Africa: A Content Analysis of Ethics Guidelines, Policies and Procedures From 22 African Countries.de Vries Jantina, Munung Syntia Nchangwi, Matimba Alice, McCurdy Sheryl, Oukem-Boyer Odile Ouwe Missi, Staunton Ciara, Yakubu Aminu, Tindana Paulina & Consortium the H3Africa - 2017 - BMC Medical Ethics 18 (1):8.
    The introduction of genomics and biobanking methodologies to the African research context has also introduced novel ways of doing science, based on values of sharing and reuse of data and samples. This shift raises ethical challenges that need to be considered when research is reviewed by ethics committees, relating for instance to broad consent, the feedback of individual genetic findings, and regulation of secondary sample access and use. Yet existing ethics guidelines and regulations in Africa do not successfully regulate research (...)
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  9.  1
    Regulation of Genomic and Biobanking Research in Africa: A Content Analysis of Ethics Guidelines, Policies and Procedures From 22 African Countries.de Vries Jantina, Munung Syntia Nchangwi, Matimba Alice, McCurdy Sheryl, Oukem-Boyer Odile Ouwe Missi, Staunton Ciara, Yakubu Aminu, Tindana Paulina & Consortium the H3Africa - 2017 - BMC Medical Ethics 18 (1):8.
    BackgroundThe introduction of genomics and biobanking methodologies to the African research context has also introduced novel ways of doing science, based on values of sharing and reuse of data and samples. This shift raises ethical challenges that need to be considered when research is reviewed by ethics committees, relating for instance to broad consent, the feedback of individual genetic findings, and regulation of secondary sample access and use. Yet existing ethics guidelines and regulations in Africa do not successfully regulate research (...)
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  10.  1
    How Do Ethnic Minority Patients Experience the Intercultural Care Encounter in Hospitals? A Systematic Review of Qualitative Research.Liesbet Degrie, Chris Gastmans, Lieslot Mahieu, Bernadette Dierckx de Casterlé & Yvonne Denier - 2017 - BMC Medical Ethics 18 (1):2.
    BackgroundIn our globalizing world, caregivers are increasingly being confronted with the challenges of providing intercultural healthcare, trying to find a dignified answer to the vulnerable situation of ethnic minority patients. Until now, international literature lacks insight in the intercultural care process as experienced by the ethnic minority patients themselves. We aim to fill this gap by analysing qualitative literature on the intercultural care encounter in the hospital setting, as experienced by ethnic minority patients.MethodsA systematic search was conducted for papers published (...)
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  11. Measuring Value Sensitivity in Medicine.Christian Ineichen, Markus Christen & Carmen Tanner - 2017 - BMC Medical Ethics 18 (1):5.
    BackgroundValue sensitivity – the ability to recognize value-related issues when they arise in practice – is an indispensable competence for medical practitioners to enter decision-making processes related to ethical questions. However, the psychological competence of value sensitivity is seldom an explicit subject in the training of medical professionals. In this contribution, we outline the traditional concept of moral sensitivity in medicine and its revised form conceptualized as value sensitivity and we propose an instrument that measures value sensitivity.MethodsWe developed an instrument (...)
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  12.  1
    Clinical Ethics Issues in HIV Care in Canada: An Institutional Ethnographic Study.Chris Kaposy, Nicole R. Greenspan, Zack Marshall, Jill Allison, Shelley Marshall & Cynthia Kitson - 2017 - BMC Medical Ethics 18 (1):9.
    BackgroundThis is a study involving three HIV clinics in the Canadian provinces of Newfoundland and Labrador, and Manitoba. We sought to identify ethical issues involving health care providers and clinic clients in these settings, and to gain an understanding of how different ethical issues are managed by these groups.MethodsWe used an institutional ethnographic method to investigate ethical issues in HIV clinics. Our researcher conducted in-depth semi-structured interviews, compiled participant observation notes, and studied health records in order to document ethical issues (...)
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  13. “I Passed the Test!” Evidence of Diagnostic Misconception in the Recruitment of Population Controls for an H3Africa Genomic Study in Cape Town, South Africa.Francis Masiye, Bongani Mayosi & Jantina de Vries - 2017 - BMC Medical Ethics 18 (1):12.
    BackgroundAdvances in genetic and genomic research have introduced challenges in obtaining informed consent for research in low and middle-income settings. However, there are only few studies that have explored challenges in obtaining informed consent in genetic and genomic research in Africa and none in South Africa. To start filling this gap, we conducted an empirical study to investigate the efficacy of informed consent procedures for an H3Africa genomic study on Rheumatic Heart Disease at the University of Cape Town in South (...)
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  14. How to Introduce Medical Ethics at the Bedside - Factors Influencing the Implementation of an Ethical Decision-Making Model.Barbara Meyer-Zehnder, Heidi Albisser Schleger, Sabine Tanner, Valentin Schnurrer, Deborah R. Vogt, Stella Reiter-Theil & Hans Pargger - 2017 - BMC Medical Ethics 18 (1):16.
    BackgroundAs the implementation of new approaches and procedures of medical ethics is as complex and resource-consuming as in other fields, strategies and activities must be carefully planned to use the available means and funds responsibly. Which facilitators and barriers influence the implementation of a medical ethics decision-making model in daily routine? Up to now, there has been little examination of these factors in this field.MethodsA medical ethics decision-making model called METAP was introduced on three intensive care units and two geriatric (...)
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  15. Human Rights Violations in Organ Procurement Practice in China.Norbert W. Paul, Arthur Caplan, Michael E. Shapiro, Charl Els, Kirk C. Allison & Huige Li - 2017 - BMC Medical Ethics 18 (1):11.
    BackgroundOver 90% of the organs transplanted in China before 2010 were procured from prisoners. Although Chinese officials announced in December 2014 that the country would completely cease using organs harvested from prisoners, no regulatory adjustments or changes in China’s organ donation laws followed. As a result, the use of prisoner organs remains legal in China if consent is obtained.DiscussionWe have collected and analysed available evidence on human rights violations in the organ procurement practice in China. We demonstrate that the practice (...)
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  16. To Change or Not to Change - Translating and Culturally Adapting the Paediatric Version of the Moral Distress Scale-Revised.Margareta af Sandeberg, Marika Wenemark, Cecilia Bartholdson, Kim Lützén & Pernilla Pergert - 2017 - BMC Medical Ethics 18 (1):14.
    BackgroundPaediatric cancer care poses ethically difficult situations that can lead to value conflicts about what is best for the child, possibly resulting in moral distress. Research on moral distress is lacking in paediatric cancer care in Sweden and most questionnaires are developed in English. The Moral Distress Scale-Revised is a questionnaire that measures moral distress in specific situations; respondents are asked to indicate both the frequency and the level of disturbance when the situation arises. The aims of this study were (...)
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  17.  1
    Beyond Cultural Stereotyping: Views on End-of-Life Decision Making Among Religious and Secular Persons in the USA, Germany, and Israel.Mark Schweda, Silke Schicktanz, Aviad Raz & Anita Silvers - 2017 - BMC Medical Ethics 18 (1):13.
    BackgroundEnd-of-life decision making constitutes a major challenge for bioethical deliberation and political governance in modern democracies: On the one hand, it touches upon fundamental convictions about life, death, and the human condition. On the other, it is deeply rooted in religious traditions and historical experiences and thus shows great socio-cultural diversity. The bioethical discussion of such cultural issues oscillates between liberal individualism and cultural stereotyping. Our paper confronts the bioethical expert discourse with public moral attitudes.MethodsThe paper is based on a (...)
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  18.  4
    Defining Reasonable Patient Standard and Preference for Shared Decision Making Among Patients Undergoing Anaesthesia in Singapore.J. L. J. Yek, A. K. Y. Lee, J. A. D. Tan, G. Y. Lin, T. Thamotharampillai & H. R. Abdullah - 2017 - BMC Medical Ethics 18 (1):6.
    BackgroundA cross-sectional study to ascertain what the Singapore population would regard as material risk in the anaesthesia consent-taking process and identify demographic factors that predict patient preferences in medical decision-making to tailor a more patient-centered informed consent.MethodsA survey was performed involving patients 21 years old and above who attended the pre-operative evaluation clinic over a 1-month period in Singapore General Hospital. Questionnaires were administered to assess patients’ perception of material risks, by trained interviewers. Patients’ demographics were obtained. Mann–Whitney U test (...)
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