Articles

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 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

The involvement of Canadian physicians in promoting and providing unproven and unapproved stem cell interventions

Direct to consumer offerings of unproven stem cell interventions (SCIs) is a pressing scientific and policy issue. According to media reports, providers of SCIs have emerged in Canada. This study provides the ...

Authors: Ubaka Ogbogu, Jenny Du and Yonida Koukio

Conscientious objection to participation in abortion by midwives and nurses: a systematic review of reasons

Freedom of conscience is a core element of human rights respected by most European countries. It allows abortion through the inclusion of a conscience clause, which permits opting out of providing such service...

Authors: Valerie Fleming, Lucy Frith, Ans Luyben and Beate Ramsayer

‘Screening audit’ as a quality assurance tool in good clinical practice compliant research environments

With the growing amount of clinical research, regulations and research ethics are becoming more stringent. This trend introduces a need for quality assurance measures for ensuring adherence to research ethics ...

Authors: Sinyoung Park, Chung Mo Nam, Sejung Park, Yang Hee Noh, Cho Rong Ahn, Wan Sun Yu, Bo Kyung Kim, Seung Min Kim, Jin Seok Kim and Sun Young Rha

Patenting human genes: Chinese academic articles’ portrayal of gene patents

The patenting of human genes has been the subject of debate for decades. While China has gradually come to play an important role in the global genomics-based testing and treatment market, little is known abou...

Authors: Li Du

Rationing elective surgery for smokers and obese patients: responsibility or prognosis?

In the United Kingdom (UK), a number of National Health Service (NHS) Clinical Commissioning Groups (CCG) have proposed controversial measures to restrict elective surgery for patients who either smoke or are ...

Authors: Virimchi Pillutla, Hannah Maslen and Julian Savulescu

Women’s perspectives on the ethical implications of non-invasive prenatal testing: a qualitative analysis to inform health policy decisions

Non-Invasive Prenatal Testing (NIPT) is a technology which provides information about fetal genetic characteristics (including sex) very early in pregnancy by examining fetal DNA obtained from a sample of mate...

Authors: Meredith Vanstone, Alexandra Cernat, Jeff Nisker and Lisa Schwartz

Skepticism towards the Swedish vision zero for suicide: interviews with 12 psychiatrists

The main causes of suicide and how suicide could and should be prevented are ongoing controversies in the scientific literature as well as in public media. In the bill on public health from 2008 (Prop 2007/08:...

Authors: Petter Karlsson, Gert Helgesson, David Titelman, Manne Sjöstrand and Niklas Juth

Forensic psychiatry, one subspecialty with two ethics? A systematic review

Forensic psychiatry is a particular subspecialty within psychiatry, dedicated in applying psychiatric knowledge and psychiatric training for particular legal purposes. Given that within the scope of forensic p...

Authors: Gérard Niveau and Ida Welle

Ethical principles and placebo-controlled trials – interpretation and implementation of the Declaration of Helsinki’s placebo paragraph in medical research

In October 2013, the Declaration of Helsinki was revised a seventh time in its 50 year history. While it is the most widely accepted set of ethical principles for the protection of patients participating in me...

Authors: Antonia-Sophie Skierka and Karin B. Michels

Educational video-assisted versus conventional informed consent for trauma-related debridement surgery: a parallel group randomized controlled trial

We investigated whether, in the emergency department (ED), educational video-assisted informed consent is superior to the conventional consent process, to inform trauma patients undergoing surgery about the pr...

Authors: Yen-Ko Lin, Chao-Wen Chen, Wei-Che Lee, Yuan-Chia Cheng, Tsung-Ying Lin, Chia-Ju Lin, Leiyu Shi, Yin-Chun Tien and Liang-Chi Kuo

Compassionate use programs in Italy: ethical guidelines

This article proposes a retrospective analysis of a compassionate use (CU), using a case study of request for Avelumab for a patient suffering from Merkel Cell Carcinoma. The study is the result of a discussio...

Authors: Ludovica De Panfilis, Roberto Satolli and Massimo Costantini

Early-career researchers’ views on ethical dimensions of patient engagement in research

Increasing attention and efforts are being put towards engaging patients in health research, and some have even argued that patient engagement in research (PER) is an ethical imperative. Yet there is relativel...

Authors: Jean-Christophe Bélisle-Pipon, Geneviève Rouleau and Stanislav Birko

Patient data and patient rights: Swiss healthcare stakeholders’ ethical awareness regarding large patient data sets – a qualitative study

There is a growing interest in aggregating more biomedical and patient data into large health data sets for research and public benefits. However, collecting and processing patient data raises new ethical issu...

Authors: Corine Mouton Dorey, Holger Baumann and Nikola Biller-Andorno

The ethics of using placebo in randomised controlled trials: a case study of a Plasmodium vivax antirelapse trial

The use of placebos in randomised controlled trials is a subject of considerable ethical debate. In this paper we present a set of considerations to evaluate the ethics of placebo controlled trials that includ...

Authors: Phaik Yeong Cheah, Norbert Steinkamp, Lorenz von Seidlein and Ric N. Price

Leaving patients to their own devices? Smart technology, safety and therapeutic relationships

This debate article explores how smart technologies may create a double-edged sword for patient safety and effective therapeutic relationships. Increasing utilization of health monitoring devices by patients w...

Authors: Anita Ho and Oliver Quick

Euthanasia and assisted suicide for people with an intellectual disability and/or autism spectrum disorder: an examination of nine relevant euthanasia cases in the Netherlands (2012–2016)

Euthanasia and assisted suicide (EAS) have been legally possible in the Netherlands since 2001, provided that statutory due care criteria are met, including: (a) voluntary and well-considered request; (b) unbe...

Authors: Irene Tuffrey-Wijne, Leopold Curfs, Ilora Finlay and Sheila Hollins

Screening for infectious diseases of asylum seekers upon arrival: the necessity of the moral principle of reciprocity

With a large number of forcibly displaced people seeking safety, the EU is facing a challenge in maintaining solidarity. Europe has seen millions of asylum seekers crossing European borders, the largest number...

Authors: Dorien T. Beeres, Darren Cornish, Machiel Vonk, Sofanne J. Ravensbergen, Els L. M. Maeckelberghe, Pieter Boele Van Hensbroek and Ymkje Stienstra

Objectivity applied to embodied subjects in health care and social security medicine: definition of a comprehensive concept of cognitive objectivity and criteria for its application

The article defines a comprehensive concept of cognitive objectivity (CCCO) applied to embodied subjects in health care. The aims of this study were: (1) to specify some necessary conditions for the definition...

Authors: Hans Magnus Solli and António Barbosa da Silva

Rules of engagement: perspectives on stakeholder engagement for genomic biobanking research in South Africa

Genomic biobanking research is undergoing exponential growth in Africa raising a host of legal, ethical and social issues. Given the scientific complexity associated with genomics, there is a growing recogniti...

Authors: Ciara Staunton, Paulina Tindana, Melany Hendricks and Keymanthri Moodley

Matters to address prior to introducing new life support technology in Japan: three serious ethical concerns related to the use of left ventricular assist devices as destination therapy and suggested policies to deal with them

Destination therapy (DT) is the permanent implantation of a left ventricular assist device (LVAD) in patients with end-stage, severe heart failure who are ineligible for heart transplantation. DT improves both...

Authors: Atsushi Asai, Sakiko Masaki, Taketoshi Okita, Aya Enzo and Yasuhiro Kadooka