Articles

Implementing clinical ethics committees as a complex intervention: presentation of a feasibility study in community care

How should clinical ethics support services such as clinical ethics committees (CECs) be implemented and evaluated? We argue that both the CEC itself and the implementation of the CEC should be considered as ‘com...

Authors: Morten Magelssen, Heidi Karlsen, Reidar Pedersen and Lisbeth Thoresen

Withholding and withdrawal of life-sustaining treatments in intensive care units in Lebanon: a cross-sectional survey of intensivists and interviews of professional societies, legal and religious leaders

Little is known about the attitudes and practices of intensivists working in Lebanon regarding withholding and withdrawing life-sustaining treatments (LSTs). The objectives of the study were to assess the poin...

Authors: Rita El Jawiche, Souheil Hallit, Lubna Tarabey and Fadi Abou-Mrad

Theory and practice of integrative clinical ethics support: a joint experience within gender affirmative care

Clinical ethics support (CES) aims to support health care professionals in dealing with ethical issues in clinical practice. Although the prevalence of CES is increasing, it does meet challenges and pressing q...

Authors: Laura Hartman, Giulia Inguaggiato, Guy Widdershoven, Annelijn Wensing-Kruger and Bert Molewijk

Street research market: dealing with scientific misconduct in Iran

Scientific misconduct is a prevalent phenomenon with many undesirable consequences. In Iran, no original research have been done about scientific fraud. So, this study aimed at describing a challenging researc...

Authors: Homayoun Sadeghi-Bazargani, Leila Nikniaz and Hamid Reza Yousefi Nodeh

“You would not be in a hurry to go back home”: patients’ willingness to participate in HIV/AIDS clinical trials at a clinical and research facility in Kampala, Uganda

Few studies have examined factors associated with willingness of people living with HIV (PLHIV) to participate in HIV treatment clinical trials in Sub-Saharan Africa. We assessed the factors associated with pa...

Authors: Deborah Ekusai Sebatta, Godfrey Siu, Henry W. Nabeta, Godwin Anguzu, Stephen Walimbwa, Mohammed Lamorde, Badru Bukenya and Andrew Kambugu

Examination and diagnosis of electronic patient records and their associated ethics: a scoping literature review

Electronic patient record (EPR) technology is a key enabler for improvements to healthcare service and management. To ensure these improvements and the means to achieve them are socially and ethically desirabl...

Authors: Tim Jacquemard, Colin P. Doherty and Mary B. Fitzsimons

In Defence of informed consent for health record research - why arguments from ‘easy rescue’, ‘no harm’ and ‘consent bias’ fail

Health data holds great potential for improved treatments. Big data research and machine learning models have been shown to hold great promise for improved diagnostics and treatment planning. The potential is ...

Authors: Thomas Ploug

Disclosure of medical errors: physicians’ knowledge, attitudes and practices (KAP) in an oncology center

Between the need for transparency in healthcare, widely promoted by patient’s safety campaigns, and the fear of negative consequences and malpractice threats, physicians face challenging decisions on whether o...

Authors: Razan Mansour, Khawlah Ammar, Amal Al-Tabba, Thalia Arawi, Asem Mansour and Maysa Al-Hussaini

Public trust and global biobank networks

Biobanks provide an important foundation for genomic and personalised medicine. In order to enhance their scientific power and scope, they are increasingly becoming part of national or international networks. ...

Authors: Lisa Dive, Christine Critchley, Margaret Otlowski, Paul Mason, Miriam Wiersma, Edwina Light, Cameron Stewart, Ian Kerridge and Wendy Lipworth

Patient distrust in pharmaceutical companies: an explanation for women under-representation in respiratory clinical trials?

Patient skepticism concerning medical innovations can have major consequences for current public health and may threaten future progress, which greatly relies on clinical research.

Authors: Laurie Pahus, Carey Meredith Suehs, Laurence Halimi, Arnaud Bourdin, Pascal Chanez, Dany Jaffuel, Julie Marciano, Anne-Sophie Gamez, Isabelle Vachier and Nicolas Molinari

Withdrawal of treatment in a pediatric intensive care unit at a Children’s Hospital in China: a 10-year retrospective study

Published data and practice recommendations on end-of-life care generally reflect Western practice frameworks; there are limited data on withdrawal of treatment for children in China.

Authors: Huaqing Liu, Dongni Su, Xubei Guo, Yunhong Dai, Xingqiang Dong, Qiujiao Zhu, Zhenjiang Bai, Ying Li and Shuiyan Wu

Conscientious objection to abortion: why it should be a specified legal right for doctors in South Korea

In 2019, the Constitutional Court of South Korea ruled that the anti-abortion provisions in the Criminal Act, which criminalize abortion, do not conform to the Constitution. This decision will lead to a total ...

Authors: Claire Junga Kim

Medical ethics: knowledge, attitude and practice among doctors in three teaching hospitals in Sri Lanka

Medical ethics deals with the ethical obligations of doctors to their patients, colleagues and society. The annual reports of Sri Lanka Medical Council indicate that the number of complaints against doctors ha...

Authors: A. W. I. P. Ranasinghe, Buddhika Fernando, Athula Sumathipala and Wasantha Gunathunga

Ethical practice in my work: community health workers’ perspectives using photovoice in Wakiso district, Uganda

Health service delivery should ensure ethical principles are observed at all levels of healthcare. Working towards this goal requires understanding the ethics-related priorities and concerns in the day-to-day ...

Authors: David Musoke, Charles Ssemugabo, Rawlance Ndejjo, Sassy Molyneux and Elizabeth Ekirapa-Kiracho

Usage of do-not-attempt-to-resuscitate orders in a Swedish community hospital – patient involvement, documentation and compliance

To characterize patients dying in a community hospital with or without attempting cardiopulmonary resuscitation (CPR) and to describe patient involvement in, documentation of, and compliance with decisions on ...

Authors: Emilie Bertilsson, Birgitta Semark, Kristina Schildmeijer, Anders Bremer and Jörg Carlsson

The ethics of DNR-decisions in oncology and hematology care: a qualitative study

In cancer care, do not resuscitate (DNR) orders are common in the terminal phase of the illness, which implies that the responsible physician in advance decides that in case of a cardiac arrest neither basic n...

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

Public awareness of and attitudes towards research biobanks in Latvia

Public awareness and engagement are among the main prerequisites for protecting the rights of research participants and for successful and sustainable functioning of research biobanks. The aim of our study was...

Authors: S. Mezinska, J. Kaleja, I. Mileiko, D. Santare, V. Rovite and L. Tzivian

Ethical and social implications of approaching death prediction in humans - when the biology of ageing meets existential issues

The discovery of biomarkers of ageing has led to the development of predictors of impending natural death and has paved the way for personalised estimation of the risk of death in the general population. This ...

Authors: Marie Gaille, Marco Araneda, Clément Dubost, Clémence Guillermain, Sarah Kaakai, Elise Ricadat, Nicolas Todd and Michael Rera

Changing medical education scenario: a wakeup call for reforms in Anatomy Act

Anatomy Act provides legal ambit to medical educationists for the acquisition of cadavers. The changing medical education scenario, socio-demographic change, and ethical concerns have necessitated an urgent re...

Authors: Rekha Lalwani, Sheetal Kotgirwar and Sunita Arvind Athavale

Motives of contributing personal data for health research: (non-)participation in a Dutch biobank

Large-scale, centralized data repositories are playing a critical and unprecedented role in fostering innovative health research, leading to new opportunities as well as dilemmas for the medical sciences. Unco...

Authors: R. Broekstra, E. L. M. Maeckelberghe, J. L. Aris-Meijer, R. P. Stolk and S. Otten

A qualitative study exploring stakeholder perspectives on the use of biological samples for future unspecified research in Malawi

There is growing interest in the collection, storage and reuse of biological samples for future research. Storage and future use of biological samples raise ethical concerns and questions about approaches that...

Authors: Limbanazo Matandika, Ruby Tionenji Ngóngóla, Khama Mita, Lucinda Manda-Taylor, Kate Gooding, Daniel Mwale, Francis Masiye and Joseph Mfutso-Bengo

Bin it or pin it? Which professional ethical guidance on managing COVID-19 should I follow?

As the COVID-19 (coronavirus) pandemic develops, healthcare professionals are looking for support with, and guidance to inform, the difficult decisions they face. In the (current) absence of an authoritative n...

Authors: Richard Huxtable

Will my patients get their residence permit? A critical analysis of the ethical dilemmas involved in writing medical certificates for residence permits in France

France has long been a country of immigration and in some respects may be seen to have a generous policy with respect to asylum seekers and access to health care for migrants. The French state notably provides...

Authors: Johann Cailhol, Marie-Christine Lebon and William Sherlaw

The patient and clinician experience of informed consent for surgery: a systematic review of the qualitative evidence

Informed consent is an integral component of good medical practice. Many researchers have investigated measures to improve the quality of informed consent, but it is not clear which techniques work best and wh...

Authors: L. J. Convie, E. Carson, D. McCusker, R. S. McCain, N. McKinley, W. J. Campbell, S. J. Kirk and M. Clarke

Family discussions and demographic factors influence adolescent’s knowledge and attitude towards organ donation after brain death: a questionnaire study

Knowledge and attitude towards organ donation are critical factors influencing organ donation rate. We aimed to assess the knowledge and attitude towards organ donation in adolescents in Austria and Switzerland.

Authors: Vanessa Stadlbauer, Christoph Zink, Paul Likar and Michael Zink

Making researchers responsible: attributions of responsibility and ambiguous notions of culture in research codes of conduct

Research codes of conduct offer guidance to researchers with respect to which values should be realized in research practices, how these values are to be realized, and what the respective responsibilities of t...

Authors: Govert Valkenburg, Guus Dix, Joeri Tijdink and Sarah de Rijcke

Evaluation of decision-making capacity in patients with dementia: challenges and recommendations from a secondary analysis of qualitative interviews

Evaluation of decision-making capacity to consent to medical treatment has proved to be difficult in patients with dementia. Studies showed that physicians are often insufficiently trained in the evaluation of...

Authors: Christopher Poppe, Bernice S. Elger, Tenzin Wangmo and Manuel Trachsel

The polysemy of psychotropic drugs: continuity and overlap between neuroenhancement, treatment, prevention, pain relief, and pleasure-seeking in a clinical setting

Enhancement involves the use of biomedical technologies to improve human capacities beyond therapeutic purposes. It has been well documented that enhancement is sometimes difficult to distinguish from treatmen...

Authors: Eisuke Sakakibara

Moral competence, moral teamwork and moral action - the European Moral Case Deliberation Outcomes (Euro-MCD) Instrument 2.0 and its revision process

Clinical Ethics Support (CES) services are offered to support healthcare professionals in dealing with ethically difficult situations. Evaluation of CES is important to understand if it is indeed a supportive ...

Authors: J. C. de Snoo-Trimp, H. C. W. de Vet, G. A. M. Widdershoven, A. C. Molewijk and M. Svantesson

The law and problematic marketing by private umbilical cord blood banks

Private umbilical cord blood banking is a for-profit industry in which parents pay to store blood for potential future use. Governments have noted the tendency for private banks to oversell the potential for c...

Authors: Blake Murdoch, Alessandro R Marcon and Timothy Caulfield

Evaluating assessment tools of the quality of clinical ethics consultations: a systematic scoping review from 1992 to 2019

Amidst expanding roles in education and policy making, questions have been raised about the ability of Clinical Ethics Committees (CEC) s to carry out effective ethics consultations (CECons). However recent re...

Authors: 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 and Lalit Kumar Radha Krishna

Relational autonomy in end-of-life care ethics: a contextualized approach to real-life complexities

Respect for autonomy is a paramount principle in end-of-life ethics. Nevertheless, empirical studies show that decision-making, exclusively focused on the individual exercise of autonomy fails to align well wi...

Authors: Carlos Gómez-Vírseda, Yves de Maeseneer and Chris Gastmans

Egyptians' social acceptance and consenting options for posthumous organ donation; a cross sectional study

Organ donation has become one of the most effective ways to save lives and improve the quality of life for patients with end-stage organ failure. No previous studies have investigated the preferences for the d...

Authors: Ammal M. Metwally, Ghada A. Abdel-Latif, Lobna Eletreby, Ahmed Aboulghate, Amira Mohsen, Hala A. Amer, Rehan M. Saleh, Dalia M. Elmosalami, Hend I. Salama, Safaa I. Abd El Hady, Raefa R. Alam, Hanan A. Mohamed, Hanan M. Badran, Hanan E. Eltokhy, Hazem Elhariri, Thanaa Rabah…

A qualitative study on aspects of consent for genomic research in communities with low literacy

Low literacy of study participants in Sub - Saharan Africa has been associated with poor comprehension during the consenting process in research participation. The concerns in comprehension are far greater whe...

Authors: Daima Bukini, Columba Mbekenga, Siana Nkya, Lisa Purvis, Sheryl McCurdy, Michael Parker and Julie Makani

No research for the decisionally-impaired mentally ill: a view from Montenegro

Many of the important elements of a valid informed consent – comprehension, voluntariness, and capacity – can be compromised or unmet in the context of psychiatric research. The inability to protect their own ...

Authors: Tea Dakić

Ethical arguments against coercing provider participation in MAiD (medical assistance in dying) in Ontario, Canada

It has historically been a crime in Canada to provide assistance to someone in ending their own life, however, this paradigm was inverted in 2015 when the Supreme Court of Canada (SCC) ruled that restrictions ...

Authors: Travis Carpenter and Lucas Vivas

Exploring the evolution of a dental code of ethics: a critical discourse analysis

What can the analysis of the evolution of a code of ethics tell us about the dental profession and the association that develops it? The establishment of codes of ethics are foundational events in the social h...

Authors: Alexander C. L. Holden

Perceptions of plagiarism by biomedical researchers: an online survey in Europe and China

Plagiarism is considered as serious research misconduct, together with data fabrication and falsification. However, little is known about biomedical researchers’ views on plagiarism. Moreover, it has been argu...

Authors: Nannan Yi, Benoit Nemery and Kris Dierickx

Self-evaluated ethical competence of a practicing physiotherapist: a national study in Finland

Patients have the right to equal, respectful treatment. Nowadays, one third of patient complaints concern health care staff’s behavior towards patients. Ethically safe care requires ethical competence, which h...

Authors: Kati KULJU, Riitta SUHONEN, Pauli PUUKKA, Anna TOLVANEN and Helena LEINO-KILPI

Medical and midwifery students’ views on the use of conscientious objection in abortion care, following legal reform in Chile: a cross-sectional study

In August 2017, Chile lifted its complete ban on abortion by permitting abortion in three limited circumstances: 1) to save a woman’s life, 2) lethal fetal anomaly, and 3) rape. The new law allows regulated us...

Authors: M. Antonia Biggs, Lidia Casas, Alejandra Ramm, C. Finley Baba and Sara P. Correa

What passive euthanasia is

Euthanasia can be thought of as being either active or passive; but the precise definition of “passive euthanasia” is not always clear. Though all passive euthanasia involves the withholding of life-sustaining...

Authors: Iain Brassington

Prioritising access to pandemic influenza vaccine: a review of the ethics literature

The world is threatened by future pandemics. Vaccines can play a key role in preventing harm, but there will inevitably be shortages because there is no possibility of advance stockpiling. We therefore need so...

Authors: Jane H. Williams and Angus Dawson

Knowledge and attitudes of physicians toward research ethics and scientific misconduct in Lebanon

Despite the implementation of codes and declarations of medical research ethics, unethical behavior is still reported among researchers. Most of the medical faculties have included topics related to medical re...

Authors: Bilal Azakir, Hassan Mobarak, Sami Al Najjar, Azza Abou El Naga and Najlaa Mashaal

Too much safety? Safeguards and equal access in the context of voluntary assisted dying legislation

In June 2019, the Australian state of Victoria joined the growing number of jurisdictions around the world to have legalised some form of voluntary assisted dying. A discourse of safety was prominent during th...

Authors: Rosalind McDougall and Bridget Pratt

Ethical issues and practical barriers in internet-based suicide prevention research: a review and investigator survey

People who are at elevated risk of suicide stand to benefit from internet-based interventions; however, research in this area is likely impacted by a range of ethical and practical challenges. The aim of this ...

Authors: Eleanor Bailey, Charlotte Mühlmann, Simon Rice, Maja Nedeljkovic, Mario Alvarez-Jimenez, Lasse Sander, Alison L. Calear, Philip J. Batterham and Jo Robinson

How do 66 European institutional review boards approve one protocol for an international prospective observational study on traumatic brain injury? Experiences from the CENTER-TBI study

The European Union (EU) aims to optimize patient protection and efficiency of health-care research by harmonizing procedures across Member States. Nonetheless, further improvements are required to increase mul...

Authors: Marjolein Timmers, Jeroen T. J. M. van Dijck, Roel P. J. van Wijk, Valerie Legrand, Ernest van Veen, Andrew I. R. Maas, David K. Menon, Giuseppe Citerio, Nino Stocchetti and Erwin J. O. Kompanje

Ethical challenges regarding the use of stem cells: interviews with researchers from Saudi Arabia

With the huge number of patients who suffer from chronic and incurable diseases, medical scientists continue to search for new curative methods for patients in dire need of treatment. Interest in stem cells is...

Authors: Ghiath Alahmad, Sarah Aljohani and Muath Fahmi Najjar

Partnering with patients in healthcare research: a scoping review of ethical issues, challenges, and recommendations for practice

Partnering with patients in healthcare research now benefits from a strong rationale and is encouraged by funding agencies and research institutions. However, this new approach raises ethical issues for patien...

Authors: Joé T. Martineau, Asma Minyaoui and Antoine Boivin

Addressing ethical challenges of disclosure in dementia prediction: limitations of current guidelines and suggestions to proceed

Biomarker research is gaining increasing attention focusing on the preclinical stages of the disease. Such interest requires special attention for communication and disclosure in clinical contexts. Many countr...

Authors: Zümrüt Alpinar-Sencan and Silke Schicktanz

COVID-19: where is the national ethical guidance?

Authors: Richard Huxtable