34 found
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  1.  26
    Clinical Ethics Committees in Norway: What Do They Do, and Does It Make a Difference?Reidun Førde & Reidar Pedersen - 2011 - Cambridge Quarterly of Healthcare Ethics 20 (3):389-395.
    The first clinical ethics committees in Norway were established in 1996. This started as an initiative from hospital clinicians, the Norwegian Medical Association, and health authorities and politicians. Norwegian hospitals are, by and large, publicly funded through taxation, and all inpatient treatment is free of charge. Today, all the 23 hospital trusts have established at least one committee. Center for Medical Ethics , University of Oslo, receives an annual amount of US$335,000 from the Ministry of Health and Care Services to (...)
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  2.  2
    Er Kliniske Etikk-Komiteer I den Kommunale Helse- Og Omsorgstjenesten Bærekraftige?Lillian Lillemoen, Irene Syse, Reidar Pedersen & Reidun Førde - 2016 - Etikk I Praksis - Nordic Journal of Applied Ethics 10 (2):127.
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  3.  13
    Ethics Reflection Groups in Community Health Services: An Evaluation Study.Lillian Lillemoen & Reidar Pedersen - 2015 - BMC Medical Ethics 16 (1):25.
    Systematic ethics support in community health services in Norway is in the initial phase. There are few evaluation studies about the significance of ethics reflection on care. The aim of this study was to evaluate systematic ethics reflection in groups in community health , - from the perspectives of employees participating in the groups, the group facilitators and the service managers. The reflection groups were implemented as part of a research and development project.
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  4.  25
    Outcomes of Moral Case Deliberation - the Development of an Evaluation Instrument for Clinical Ethics Support (the Euro-MCD).Mia Svantesson, Jan Karlsson, Pierre Boitte, Jan Schildman, Linda Dauwerse, Guy Widdershoven, Reidar Pedersen, Martijn Huisman & Bert Molewijk - 2014 - BMC Medical Ethics 15 (1):30.
    Clinical ethics support, in particular Moral Case Deliberation, aims to support health care providers to manage ethically difficult situations. However, there is a lack of evaluation instruments regarding outcomes of clinical ethics support in general and regarding Moral Case Deliberation (MCD) in particular. There also is a lack of clarity and consensuses regarding which MCD outcomes are beneficial. In addition, MCD outcomes might be context-sensitive. Against this background, there is a need for a standardised but flexible outcome evaluation instrument. The (...)
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  5.  11
    Ethical Challenges and How to Develop Ethics Support in Primary Health Care.Lillian Lillemoen & Reidar Pedersen - 2013 - Nursing Ethics 20 (1):96-108.
    Ethics support in primary health care has been sparser than in hospitals, the need for ethics support is probably no less. We have, however, limited knowledge about how to develop ethics support that responds to primary health-care workers’ needs. In this article, we present a survey with a mixture of closed- and open-ended questions concerning: How frequent and how distressed various types of ethical challenges make the primary health-care workers feel, how important they think it is to deal with these (...)
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  6.  12
    Clinicians' Evaluation of Clinical Ethics Consultations in Norway: A Qualitative Study. [REVIEW]Reidun Førde, Reidar Pedersen & Victoria Akre - 2008 - Medicine, Health Care and Philosophy 11 (1):17-25.
    Clinical ethics committees have existed in Norway since 1996. By now all hospital trusts have one. An evaluation of these committees’ work was started in 2004. This paper presents results from an interview study of eight clinicians who evaluated six committees’ deliberations on 10 clinical cases. The study indicates that the clinicians found the clinical ethics consultations useful and worth while doing. However, a systematic approach to case consultations is vital. Procedures and mandate of the committees should be known to (...)
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  7.  24
    Ethical Challenges in Connection with the Use of Coercion: A Focus Group Study of Health Care Personnel in Mental Health Care.Marit H. Hem, Bert Molewijk & Reidar Pedersen - 2014 - BMC Medical Ethics 15 (1):82.
    In recent years, the attention on the use of coercion in mental health care has increased. The use of coercion is common and controversial, and involves many complex ethical challenges. The research question in this study was: What kind of ethical challenges related to the use of coercion do health care practitioners face in their daily clinical work?
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  8.  2
    Clinical Ethics Committees – Also for Mental Health Care? The Norwegian Experience.Irene Syse, Reidun Førde & Reidar Pedersen - 2016 - Clinical Ethics 11 (2-3):81-86.
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  9.  8
    Ethics Support in Community Care Makes a Difference for Practice.Morten Magelssen, Elisabeth Gjerberg, Lillian Lillemoen, Reidun Førde & Reidar Pedersen - 2018 - Nursing Ethics 25 (2):165-173.
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  10.  37
    Barriers and Challenges in Clinical Ethics Consultations: The Experiences of Nine Clinical Ethics Committees.Reidar Pedersen, Victoria Akre & Reidun Førde - 2009 - Bioethics 23 (8):460-469.
    Clinical ethics committees have recently been established in nearly all Norwegian hospital trusts. One important task for these committees is clinical ethics consultations. This qualitative study explores significant barriers confronting the ethics committees in providing such consultation services. The interviews with the committees indicate that there is a substantial need for clinical ethics support services and, in general, the committee members expressed a great deal of enthusiasm for the committee work. They also reported, however, that tendencies to evade moral disagreement, (...)
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  11.  21
    Dealing with Ethical Challenges: A Focus Group Study with Professionals in Mental Health Care.Bert Molewijk, Marit Helene Hem & Reidar Pedersen - 2015 - BMC Medical Ethics 16 (1):4.
    Little is known about how health care professionals deal with ethical challenges in mental health care, especially when not making use of a formal ethics support service. Understanding this is important in order to be able to support the professionals, to improve the quality of care, and to know in which way future ethics support services might be helpful.
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  12.  1
    The Significance of Ethics Reflection Groups in Mental Health Care: A Focus Group Study Among Health Care Professionals.Marit Helene Hem, Bert Molewijk, Elisabeth Gjerberg, Lillian Lillemoen & Reidar Pedersen - 2018 - BMC Medical Ethics 19 (1):54.
    Professionals within the mental health services face many ethical dilemmas and challenging situations regarding the use of coercion. The purpose of this study was to evaluate the significance of participating in systematic ethics reflection groups focusing on ethical challenges related to coercion. In 2013 and 2014, 20 focus group interviews with 127 participants were conducted. The interviews were tape recorded and transcribed verbatim. The analysis is inspired by the concept of ‘bricolage’ which means our approach was inductive. Most participants report (...)
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  13.  8
    Ethical Challenges When Using Coercion in Mental Healthcare: A Systematic Literature Review.Marit Helene Hem, Elisabeth Gjerberg, Tonje Lossius Husum & Reidar Pedersen - 2018 - Nursing Ethics 25 (1):92-110.
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  14.  7
    Ethics in Municipal Health Services: Working Systematically with, and Developing Competence in Ethics.Lillian Lillemoen & Reidar Pedersen - 2013 - Clinical Ethics 8 (1):19-28.
    The Norwegian Parliament has decided to give priority to ethics in municipal health services. This priority is supposed to raise competence in ethics within municipal health services. As part of the national project, the participating municipalities were encouraged to develop and carry out local projects. In this article, we present a local ethics project in one of the participating municipalities in central eastern Norway. The local project for raising competence in ethics was carried out in cooperation with researchers at the (...)
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  15.  2
    How to Succeed with Ethics Reflection Groups in Community Healthcare? Professionals’ Perceptions.Heidi Karlsen, Lillian Lillemoen, Morten Magelssen, Reidun Førde, Reidar Pedersen & Elisabeth Gjerberg - forthcoming - Nursing Ethics:096973301774795.
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  16.  14
    Empathy: A Wolf in Sheep’s Clothing? [REVIEW]Reidar Pedersen - 2008 - Medicine, Health Care and Philosophy 11 (3):325-335.
    Empathy is generally regarded as important and positive. However, descriptions of empathy are often inadequate and deceptive. Furthermore, there is a widespread lack of critical attention to such deficiencies. This critical review of the medical discourse of empathy shows that tendencies to evade and misrepresent the understanding subject are common. The understanding subject’s contributions to the empathic process are often neglected or described as something that can and should be avoided or controlled. Furthermore, the intrinsic and closely interwoven relationship between (...)
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  17.  1
    Patients’ Moral Views on Coercion in Mental Healthcare.Reidun Norvoll & Reidar Pedersen - forthcoming - Nursing Ethics:096973301667476.
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  18. Staff’s Normative Attitudes Towards Coercion: The Role of Moral Doubt and Professional Context—a Cross-Sectional Survey Study.Bert Molewijk, Almar Kok, Tonje Husum, Reidar Pedersen & Olaf Aasland - 2017 - BMC Medical Ethics 18 (1):37.
    The use of coercion is morally problematic and requires an ongoing critical reflection. We wondered if not knowing or being uncertain whether coercion is morally right or justified is related to professionals’ normative attitudes regarding the use of coercion. This paper describes an explorative statistical analysis based on a cross-sectional survey across seven wards in three Norwegian mental health care institutions. Descriptive analyses showed that in general the 379 respondents a) were not so sure whether coercion should be seen as (...)
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  19.  1
    Barriers and Challenges in Clinical Ethics Consultations: The Experiences of Nine Clinical Ethics Committees: Country Reports.Reidar Pedersen - 2009 - Bioethics 23 (8):460-469.
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  20.  11
    The Role of Ethics in Reducing and Improving the Quality of Coercion in Mental Health Care.Reidun Norvoll, Marit Helene Hem & Reidar Pedersen - 2017 - HEC Forum 29 (1):59-74.
    Coercion in mental health care gives rise to many ethical challenges. Many countries have recently implemented state policy programs or development projects aiming to reduce coercive practices and improve their quality. Few studies have explored the possible role of ethics in such initiatives. This study adds to this subject by exploring health professionals’ descriptions of their ethical challenges and strategies in everyday life to ensure morally justified coercion and best practices. Seven semi-structured telephone interviews were carried out in 2012 with (...)
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  21.  12
    Four Roles of Ethical Theory in Clinical Ethics Consultation.Morten Magelssen, Reidar Pedersen & Reidun Førde - 2016 - American Journal of Bioethics 16 (9):26-33.
    When clinical ethics committee members discuss a complex ethical dilemma, what use do they have for normative ethical theories? Members without training in ethical theory may still contribute to a pointed and nuanced analysis. Nonetheless, the knowledge and use of ethical theories can play four important roles: aiding in the initial awareness and identification of the moral challenges, assisting in the analysis and argumentation, contributing to a sound process and dialogue, and inspiring an attitude of reflexivity. These four roles of (...)
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  22.  9
    How to Avoid and Prevent Coercion in Nursing Homes A Qualitative Study.Elisabeth Gjerberg, Marit Helene Hem, Reidun Førde & Reidar Pedersen - 2013 - Nursing Ethics 20 (6):632-644.
    In many Western countries, studies have demonstrated extensive use of coercion in nursing homes, especially towards patients suffering from dementia. This article examines what kinds of strategies or alternative interventions nursing staff in Norway used when patients resist care and treatment and what conditions the staff considered as necessary to succeed in avoiding the use of coercion. The data are based on interdisciplinary focus group interviews with nursing home staff. The study revealed that the nursing home staff usually spent a (...)
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  23.  19
    How Do Nursing Home Doctors Involve Patients and Next of Kin in End-of-Life Decisions? A Qualitative Study From Norway.Maria Romøren, Reidar Pedersen & Reidun Førde - 2016 - BMC Medical Ethics 17 (1):1-8.
    BackgroundEthically challenging critical events and decisions are common in nursing homes. This paper presents nursing home doctors’ descriptions of how they include the patient and next of kin in end-of-life decisions.MethodsWe performed ten focus groups with 30 nursing home doctors. Advance care planning; aspects of decisions on life-prolonging treatment, and conflict with next of kin were subject to in-depth analysis and condensation.ResultsThe doctors described large variations in attitudes and practices in all aspects of end-of-life decisions. In conflict situations, many doctors (...)
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  24.  1
    How to Avoid and Prevent Coercion in Nursing Homes.Elisabeth Gjerberg, Marit Helene Hem, Reidun Førde & Reidar Pedersen - 2013 - Nursing Ethics 20 (6):632-644.
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  25.  21
    Novel Paths to Relevance: How Clinical Ethics Committees Promote Ethical Reflection.Morten Magelssen, Reidar Pedersen & Reidun Førde - 2016 - HEC Forum 28 (3):205-216.
    How may clinical ethics committees inspire ethical reflection among healthcare professionals? How may they deal with organizational ethics issues? In recent years, Norwegian CECs have attempted different activites that stretch or go beyond the standard trio of education, consultation, and policy work. We studied the novel activities of Norwegian CECs by examining annual reports and interviewing CEC members. Through qualitative analysis we identified nine categories of novel CEC activities, which we describe by way of examples. In light of the findings, (...)
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  26.  4
    The Silent World of Young Next of Kin in Mental Healthcare.Elin Håkonsen Martinsen, Bente M. Weimand, Reidar Pedersen & Reidun Norvoll - forthcoming - Nursing Ethics:096973301769449.
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  27.  6
    The Norwegian National Project for Ethics Support in Community Health and Care Services.Morten Magelssen, Elisabeth Gjerberg, Reidar Pedersen, Reidun Førde & Lillian Lillemoen - 2016 - BMC Medical Ethics 17 (1):70.
    BackgroundInternationally, clinical ethics support has yet to be implemented systematically in community health and care services. A large-scale Norwegian project attempted to increase ethical competence in community services through facilitating the implementation of ethics support activities in 241 Norwegian municipalities. The article describes the ethics project and the ethics activities that ensued.MethodsThe article first gives an account of the Norwegian ethics project. Then the results of two online questionnaires are reported, characterizing the scope, activities and organization of the ethics activities (...)
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  28.  2
    Roles and Responsibilities of Clinical Ethics Committees in Priority Setting.Morten Magelssen, Ingrid Miljeteig, Reidar Pedersen & Reidun Førde - 2017 - BMC Medical Ethics 18 (1):1-8.
    Background Fair prioritization of healthcare resources has been on the agenda for decades, but resource allocation dilemmas in clinical practice remain challenging. Can clinical ethics committees be of help? The aim of the study was to explore whether and how CECs handle priority setting dilemmas and contribute to raising awareness of fairness concerns. Method Descriptions of activities involving priority setting in annual reports from Norwegian CECs were studied and categorized through qualitative content analysis. Results Three hundred thirty-nine reports from 38 (...)
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  29.  7
    Coercion in Nursing Homes.Elisabeth Gjerberg, Lillian Lillemoen, Reidar Pedersen & Reidun Førde - 2016 - Nursing Ethics 23 (3):253-264.
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  30.  1
    Roles and responsibilities of clinical ethics committees in priority setting.Morten Magelssen, Ingrid Miljeteig, Reidar Pedersen & Reidun Førde - 2017 - Bmc Medical Ethics 2017 18:1 18 (1):68.
    Fair prioritization of healthcare resources has been on the agenda for decades, but resource allocation dilemmas in clinical practice remain challenging. Can clinical ethics committees be of help? The aim of the study was to explore whether and how CECs handle priority setting dilemmas and contribute to raising awareness of fairness concerns. Descriptions of activities involving priority setting in annual reports from Norwegian CECs were studied and categorized through qualitative content analysis. Three hundred thirty-nine reports from 38 CECs were studied. (...)
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  31.  2
    Next of Kin’s Experiences of Involvement During Involuntary Hospitalisation and Coercion.Reidun Førde, Reidun Norvoll, Marit Helene Hem & Reidar Pedersen - 2016 - BMC Medical Ethics 17 (1):76.
    BackgroundNorway has extensive and detailed legal requirements and guidelines concerning involvement of next of kin during involuntary hospital treatment of seriously mentally ill patients. However, we have little knowledge about what happens in practice. This study explores NOK’s views and experiences of involvement during involuntary hospitalisation in Norway.MethodsWe performed qualitative interviews-focus groups and individual-with 36 adult NOK to adults and adolescents who had been involuntarily admitted once or several times. The semi-structured interview guide included questions on experiences with and views (...)
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  32.  3
    Clinical Ethics Consultation: Theories and Methods, Implementation, Evaluation – Edited by Jan Schildman, John-Steward Gordon and Jochen Vollmann.Reidar Pedersen - 2011 - Bioethics 25 (7):425-426.
  33. Etisk kompetanseheving i norske kommuner – hva er gjort, og hva har vært levedyktig over tid?Elisabeth Gjerberg, Lillian Lillemoen, Anne Dreyer, Reidar Pedersen & Reidun Førde - 2014 - Etikk I Praksis - Nordic Journal of Applied Ethics 8 (2).
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  34. Involvement in Decisions About Intravenous Treatment for Nursing Home Patients: Nursing Homes Versus Hospital Wards.Kristin Klomstad, Reidar Pedersen, Reidun Førde & Maria Romøren - 2018 - BMC Medical Ethics 19 (1):34.
    Many of the elderly in nursing homes are very ill and have a reduced quality of life. Life expectancy is often hard to predict. Decisions about life-prolonging treatment should be based on a professional assessment of the patient’s best interest, assessment of capacity to consent, and on the patient’s own wishes. The purpose of this study was to investigate and compare how these types of decisions were made in nursing homes and in hospital wards. Using a questionnaire, we studied the (...)
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