Articles

Conscientious objection to intentional killing: an argument for toleration

In the debate on conscientious objection in healthcare, proponents of conscience rights often point to the imperative to protect the health professional’s moral integrity. Their opponents hold that the moral i...

Authors: Bjørn K. Myskja and Morten Magelssen

Exploring neurologists’ perspectives on the return of next generation sequencing results to their patients: a needed step in the development of guidelines

The use of Next Generation Sequencing such as Whole Genome Sequencing (WGS) is a promising step towards a better understanding and treatment of neurological diseases. WGS can result into unexpected information...

Authors: Thierry Hurlimann, Iris Jaitovich Groisman and Béatrice Godard

Attitudes to prenatal screening among Norwegian citizens: liberality, ambivalence and sensitivity

Norway’s liberal abortion law allows for abortion on social indications, yet access to screening for fetal abnormalities is restricted. Norwegian regulation of, and public discourse about prenatal screening an...

Authors: Morten Magelssen, Berge Solberg, Magne Supphellen and Guttorm Haugen

What information and the extent of information research participants need in informed consent forms: a multi-country survey

The use of lengthy, detailed, and complex informed consent forms (ICFs) is of paramount concern in biomedical research as it may not truly promote the rights and interests of research participants. The extent ...

Authors: Juntra Karbwang, Nut Koonrungsesomboon, Cristina E. Torres, Edlyn B. Jimenez, Gurpreet Kaur, Roli Mathur, Eti N. Sholikhah, Chandanie Wanigatunge, Chih-Shung Wong, Kwanchanok Yimtae, Murnilina Abdul Malek, Liyana Ahamad Fouzi, Aisyah Ali, Beng Z. Chan, Madawa Chandratilake, Shoen C. Chiew…

A bioethical framework to guide the decision-making process in the care of seriously ill patients

One of the biggest challenges of practicing medicine in the age of informational technology is how to conciliate the overwhelming amount of medical-scientific information with the multiple patients’ values of ...

Authors: Daniel Neves Forte, Fernando Kawai and Cláudio Cohen

Reuse of cardiac organs in transplantation: an ethical analysis

This paper examines the ethical aspects of organ transplant surgery in which a donor heart is transplanted from a first recipient, following determination of death by neurologic criteria, to a second recipient...

Authors: Eisuke Nakazawa, Shoichi Maeda, Keiichiro Yamamoto, Aru Akabayashi, Yuzaburo Uetake, Margie H. Shaw, Richard A. Demme and Akira Akabayashi

Frequency of use of the religious exemption in New Jersey cases of determination of brain death

The 1981 Uniform Determination of Death Act (UDDA) established the validity of both cardio-respiratory and neurological criteria of death. However, many religious traditions including most forms of Haredi Juda...

Authors: Rachel Grace Son and Susan M. Setta

The values and ethical commitments of doctors engaging in macroallocation: a qualitative and evaluative analysis

In most socialised health systems there are formal processes that manage resource scarcity and determine the allocation of funds to health services in accordance with their priority. In this analysis, part of ...

Authors: Siun Gallagher, Miles Little and Claire Hooker

Beyond ‘health and safety’ – the challenges facing students asked to work outside of their comfort, qualification level or expertise on medical elective placement

On elective students may not always be clear about safeguarding themselves and others. It is important that placements are safe, and ethically grounded. A concern for medical schools is equipping their student...

Authors: Connie Wiskin, Jonathan Dowell and Catherine Hale

A systematic review of the literature on ethical aspects of transitional care between child- and adult-orientated health services

Healthcare policy and academic literature have promoted improving the transitional care of young people leaving child and adolescent mental health services (CAMHS). Despite the availability of guidance on good...

Authors: Moli Paul, Lesley O’Hara, Priya Tah, Cathy Street, Athanasios Maras, Diane Purper Ouakil, Paramala Santosh, Giulia Signorini, Swaran Preet Singh, Helena Tuomainen and Fiona McNicholas

Setting standards for empirical bioethics research: a response to Carter and Cribb

This paper responds to the commentaries from Stacy Carter and Alan Cribb. We pick up on two main themes in our response. First, we reflect on how the process of setting standards for empirical bioethics resear...

Authors: Michael Dunn, Jonathan Ives, Bert Molewijk and Jan Schildmann

Debating diversity: a commentary on Standards of practice in empirical bioethics research

This article provides a commentary on Standards of practice in empirical bioethics research by Ives and colleagues (in this Issue). There is much to admire in the paper, and in the demanding consensus-building pr...

Authors: Stacy M. Carter

Predictors of consent to cell line creation and immortalisation in a South African schizophrenia genomics study

Cell line immortalisation is a growing component of African genomics research and biobanking. However, little is known about the factors influencing consent to cell line creation and immortalisation in African...

Authors: Megan M. Campbell, Jantina de Vries, Sibonile G. Mqulwana, Michael M. Mndini, Odwa A. Ntola, Deborah Jonker, Megan Malan, Adele Pretorius, Zukiswa Zingela, Stephanus Van Wyk, Dan J. Stein and Ezra Susser

Let’s talk about standards: a commentary on standards of practice in empirical bioethics

This commentary welcomes the work of Ives et al. on Standards of practice in Empirical Bioethics, and especially the dialogical spirit in which the standards have been constructed and offered. It also raises s...

Authors: Alan Cribb

Standards of practice in empirical bioethics research: towards a consensus

This paper reports the process and outcome of a consensus finding project, which began with a meeting at the Brocher Foundation in May 2015. The project sought to generate and reach consensus on standards of p...

Authors: Jonathan Ives, Michael Dunn, Bert Molewijk, Jan Schildmann, Kristine Bærøe, Lucy Frith, Richard Huxtable, Elleke Landeweer, Marcel Mertz, Veerle Provoost, Annette Rid, Sabine Salloch, Mark Sheehan, Daniel Strech, Martine de Vries and Guy Widdershoven

Ethics of task shifting in the health workforce: exploring the role of community health workers in HIV service delivery in low- and middle-income countries

Task shifting is increasingly used to address human resource shortages impacting HIV service delivery in low- and middle-income countries. By shifting basic tasks from higher- to lower-trained cadres, such as ...

Authors: Hayley Mundeva, Jeremy Snyder, David Paul Ngilangwa and Angela Kaida

Their view: difficulties and challenges of patients and physicians in cross-cultural encounters and a medical ethics perspective

In todays’ super-diverse societies, communication and interaction in clinical encounters are increasingly shaped by linguistic, cultural, social and ethnic complexities. It is crucial to better understand the ...

Authors: Kristina Würth, Wolf Langewitz, Stella Reiter-Theil and Sylvie Schuster

Management of financial conflicts of interests in clinical practice guidelines in Germany: results from the public database GuidelineWatch

The reliability of clinical practice guidelines has been disputed because guideline panel members are often burdened with financial conflicts of interest (COI). Current recommendations for COI regulation advis...

Authors: Hendrik Napierala, Luise Schäfer, Gisela Schott, Niklas Schurig and Thomas Lempert

Good health checks according to the general public; expectations and criteria: a focus group study

Health checks or health screenings identify (risk factors for) disease in people without a specific medical indication. So far, the perspective of (potential) health check users has remained underexposed in di...

Authors: Yrrah H. Stol, Eva C. A. Asscher and Maartje H. N. Schermer

Ethical competence in DNR decisions –a qualitative study of Swedish physicians and nurses working in hematology and oncology care

DNR decisions are frequently made in oncology and hematology care and physicians and nurses may face related ethical dilemmas. Ethics is considered a basic competence in health care and can be understood as a ...

Authors: Mona Pettersson, Mariann Hedström and Anna T. Höglund

Ethical challenges assessed in the clinical ethics Committee of Psychiatry in the region of Southern Denmark in 2010–2015: a qualitative content analyses

The aim of this article is to give more insight into what ethical challenges clinicians in mental healthcare experience and discuss with a Clinical Ethics Committee in psychiatry in the Region of Southern Denm...

Authors: H. Bruun, S. G. Lystbaek, E. Stenager, L. Huniche and R. Pedersen

Ethical concerns on sharing genomic data including patients’ family members

Platforms for sharing genomic and phenotype data have been developed to promote genomic research, while maximizing the utility of existing datasets and minimizing the burden on participants. The value of genom...

Authors: Kyoko Takashima, Yuichi Maru, Seiichi Mori, Hiroyuki Mano, Tetsuo Noda and Kaori Muto

In pursuit of goodness in bioethics: analysis of an exemplary article

What is good bioethics? Addressing this question is key for reinforcing and developing the field. In particular, a discussion of potential quality criteria can heighten awareness and contribute to the quality ...

Authors: Bjørn Hofmann and Morten Magelssen

Introduction to Ethics and Global Health

Authors: Beatrice Godard, Slim Haddad, Robert Huish and Daniel Weinstock

The ethics of relationality in implementation and evaluation research in global health: reflections from the Dream-A-World program in Kingston, Jamaica

Despite recent developments aimed at creating international guidelines for ethical global health research, critical disconnections remain between how global health research is conducted in the field and the in...

Authors: Nicole A. D’souza, Jaswant Guzder, Frederick Hickling and Danielle Groleau

Deconstructing the notion of “global health research partnerships” across Northern and African contexts

Global health conceives the notion of partnership between North and South as central to the foundations of this academic field. Indeed, global health aspires to an equal positioning of Northern and Southern ac...

Authors: Lara Gautier, Isidore Sieleunou and Albino Kalolo

Integrated primary health care in low- and middle-income countries: a double challenge

The lack of primary healthcare integration has been identified as one of the main limits to programs’ efficacy in low- and middle-income countries. This is especially relevant to the Millennium Development Goa...

Authors: Thomas Druetz

Differences and structural weaknesses of institutional mechanisms for health research ethics: Burkina Faso, Palestine, Peru, and Democratic Republic of the Congo

Regardless of national contexts, the institutions responsible for research ethics, founded on international regulations, are all expected to be structured and to operate in a common way. Our experience with se...

Authors: N’koué Emmanuel Sambiéni

Right to health and social justice in Bangladesh: ethical dilemmas and obligations of state and non-state actors to ensure health for urban poor

The world is urbanizing rapidly; more than half the world’s population now lives in urban areas, leading to significant transition in lifestyles and social behaviours globally. While offering many advantages, ...

Authors: Sohana Shafique, Dipika S. Bhattacharyya, Iqbal Anwar and Alayne Adams

A reflection on the challenge of protecting confidentiality of participants while disseminating research results locally

Researchers studying health systems in low-income countries face a myriad of ethical challenges throughout the entire research process. In this article, we discuss one of the greatest ethical challenges that w...

Authors: Anne-Marie Turcotte-Tremblay and Esther Mc Sween-Cadieux

Community involvement in biomedical research conducted in the global health context; what can be done to make it really matter?

Community involvement in research has been advocated by researchers, communities, regulatory agencies, and funders with the aim of reinforcing subjects’ protection and improving research efficiency. Community ...

Authors: Federica Fregonese

Commodification of care and its effects on maternal health in the Noun division (West Region – Cameroon)

Since the mid-1980s, there has been a gradual ethical drift in the provision of maternal care in African health facilities in general, and in Cameroon in particular, despite government efforts. In fact, in Cam...

Authors: Ibrahim Bienvenu Mouliom Moungbakou

Ethics beyond ethics: the need for virtuous researchers

Research ethics boards (REBs) exist for good reason. By setting rules of ethical behaviour, REBs can help mitigate the risk of researchers causing harm to their research participants. However, the current meth...

Authors: Mark Daku

Ethical issues related to human papillomavirus vaccination programs: an example from Bangladesh

Human Papilloma Virus (HPV) vaccine was introduced in Bangladesh through the arrangement of a demonstration project in Gazipur district in 2016, targeting grade five female students and non-school going girls ...

Authors: Marium Salwa and Tarek Abdullah Al-Munim

Evaluation as institution: a contractarian argument for needs-based economic evaluation

There is a gap between health economic evaluation methods and the value judgments of coverage decision makers, at least in Germany. Measuring preference satisfaction has been claimed to be inappropriate for al...

Authors: Wolf H. Rogowski

Advance directive: does the GP know and address what the patient wants? Advance directive in primary care

Due to the rapid changes in the medical world and the aging population, the need for advanced care planning grows.

Authors: Guda Scholten, Sofie Bourguignon, Anthony Delanote, Bieke Vermeulen, Geert Van Boxem and Birgitte Schoenmakers

Opening the debate on deep brain stimulation for Alzheimer disease – a critical evaluation of rationale, shortcomings, and ethical justification

Deep brain stimulation (DBS) as investigational intervention for symptomatic relief from Alzheimer disease (AD) has generated big expectations. Our aim is to discuss the ethical justification of this research ...

Authors: Merlin Bittlinger and Sabine Müller

Identification of ethics committees based on authors’ disclosures: cross-sectional study of articles published in the European Journal of Anaesthesiology and a survey of ethics committees

Since 2010, the European Journal of Anaesthesiology has required the reporting of five items concerning ethical approval in articles describing human research: ethics committee’s name and address, chairperson’...

Authors: Davide Zoccatelli, Martin R. Tramèr and Nadia Elia

Medicine, market and communication: ethical considerations in regard to persuasive communication in direct-to-consumer genetic testing services

Commercial genetic testing offered over the internet, known as direct-to-consumer genetic testing (DTC GT), currently is under ethical attack. A common critique aims at the limited validation of the tests as w...

Authors: Manuel Schaper and Silke Schicktanz

Leadership in palliative medicine: moral, ethical and educational

Making particular use of Shale’s analysis, this paper discusses the notion of leadership in the context of palliative medicine. Whilst offering a critical perspective, I build on the philosophy of palliative c...

Authors: Nathan Emmerich

The significance of ethics reflection groups in mental health care: a focus group study among health care professionals

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 ...

Authors: Marit Helene Hem, Bert Molewijk, Elisabeth Gjerberg, Lillian Lillemoen and Reidar Pedersen

The dual use of research ethics committees: why professional self-governance falls short in preserving biosecurity

Dual Use Research of Concern (DURC) constitutes a major challenge for research practice and oversight on the local, national and international level. The situation in Germany is shaped by two partly competing ...

Authors: Sabine Salloch

The patient perspective in health care networks

Health care organization is entering a new age. Focus is increasingly shifting from individual health care institutions to interorganizational collaboration and health care networks. Much hope is set on such n...

Authors: Kasper Raus, Eric Mortier and Kristof Eeckloo

Changes in attitudes towards hastened death among Finnish physicians over the past sixteen years

The ethics of hastened death are complex. Studies on physicians’ opinions about assisted dying (euthanasia or assisted suicide) exist, but changes in physicians’ attitudes towards hastened death in clinical de...

Authors: Reetta P. Piili, Riina Metsänoja, Heikki Hinkka, Pirkko-Liisa I. Kellokumpu-Lehtinen and Juho T. Lehto

Surgical informed consent in obstetric and gynecologic surgeries: experience from a comprehensive teaching hospital in Southern Ethiopia

Surgical Informed Consent (SIC) has long been recognized as an important component of modern medicine. The ultimate goals of SIC are to improve clients’ understanding of the intended procedure, increase client...

Authors: Million Teshome, Zenebe Wolde, Abel Gedefaw, Mequanent Tariku and Anteneh Asefa

Research ethics review at University Eduardo Mondlane (UEM)/Maputo Central Hospital, Mozambique (2013–2016): a descriptive analysis of the start-up of a new research ethics committee (REC)

Mozambique has seen remarkable growth in biomedical research over the last decade. To meet a growing need, the National Committee for Bioethics in Health of Mozambique (CNBS) encouraged the development of ethi...

Authors: Jahit Sacarlal, Vasco Muchanga, Carlos Mabutana, Matilde Mabui, Arlete Mariamo, Assa Júlio Cuamba, Leida Artur Fumo, Jacinta Silveira, Elizabeth Heitman and Troy D. Moon

A scoping review of reporting ‘Ethical Research Practices’ in research conducted among refugees and war-affected populations in the Arab world

Ethical research conduct is a cornerstone of research practice particularly when research participants include vulnerable populations. This study mapped the extent of reporting ethical research practices in studi...

Authors: Jihad Makhoul, Rana F. Chehab, Zahraa Shaito and Abla M. Sibai

Translating and culturally adapting the shortened version of the Hospital Ethical Climate Survey (HECS-S) – retaining or modifying validated instruments

The Hospital Ethical Climate Survey (HECS) was developed in the USA and later shortened (HECS-S). HECS has previously been translated into Swedish and the aim of this study was to describe a process of transla...

Authors: Pernilla Pergert, Cecilia Bartholdson, Marika Wenemark, Kim Lützén and Margareta af Sandeberg

Involvement in decisions about intravenous treatment for nursing home patients: nursing homes versus hospital wards

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 asses...

Authors: Kristin Klomstad, Reidar Pedersen, Reidun Førde and Maria Romøren

Complexity of consenting for medical termination of pregnancy: prospective and longitudinal study in Paris

We analyzed the patients’ perception of prenatal diagnosis of fetal cardiac pathology, and the reasons for choosing to continue with pregnancy despite being eligible to receive a medical termination of pregnan...

Authors: Georges Abi Tayeh, Jean-Marie Jouannic, Fersan Mansour, Assaad Kesrouani and Elie Attieh