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Medical Principles and Practice :... 2021An overview of ethics and clinical ethics is presented in this review. The 4 main ethical principles, that is beneficence, nonmaleficence, autonomy, and justice, are... (Review)
Review
An overview of ethics and clinical ethics is presented in this review. The 4 main ethical principles, that is beneficence, nonmaleficence, autonomy, and justice, are defined and explained. Informed consent, truth-telling, and confidentiality spring from the principle of autonomy, and each of them is discussed. In patient care situations, not infrequently, there are conflicts between ethical principles (especially between beneficence and autonomy). A four-pronged systematic approach to ethical problem-solving and several illustrative cases of conflicts are presented. Comments following the cases highlight the ethical principles involved and clarify the resolution of these conflicts. A model for patient care, with caring as its central element, that integrates ethical aspects (intertwined with professionalism) with clinical and technical expertise desired of a physician is illustrated.
Topics: Beneficence; Confidentiality; Ethics, Clinical; Humans; Informed Consent; Morals; Negotiating; Patient-Centered Care; Personal Autonomy; Problem Solving; Social Justice; Truth Disclosure
PubMed: 32498071
DOI: 10.1159/000509119 -
Bundesgesundheitsblatt,... Mar 2022The term "quality" in healthcare is frequently used but defined in different ways. On the one hand, quality describes the nature or characteristic of things and is... (Review)
Review
The term "quality" in healthcare is frequently used but defined in different ways. On the one hand, quality describes the nature or characteristic of things and is descriptive in this respect. In quality management and quality assurance, however, the focus is on the normative dimension of quality, referring to the evaluation of structures, processes, or results of actions in the context of healthcare. There are several links between ethical considerations in healthcare and quality of healthcare. First, the provision and assurance of high quality is an ethical imperative, mandated by the principles of beneficence and nonmaleficence. However, for high ethical quality of care, the ethical principles of respect for patient autonomy and justice must also be considered. Last but not least, the determination and justification of what "good" or "high" quality in healthcare means must be reflected from an ethical perspective. This article analyses these ethical dimensions of quality management and quality assurance. To achieve this goal, it first explains which ethical requirements have to be considered as quality criteria in patient care. Subsequently, ethically relevant challenges in determining quality in healthcare are identified based on criteria of outcome quality, and the teaching of professional competencies in medical education is discussed as a possible contribution to quality and quality assurance in healthcare. The paper concludes with considerations on determining and assuring quality under conditions of limited healthcare resources.
Topics: Beneficence; Delivery of Health Care; Germany; Humans; Personal Autonomy; Social Justice
PubMed: 35129623
DOI: 10.1007/s00103-022-03492-4 -
Applied Nursing Research : ANR Dec 2021The ANA Code of Ethics for Nurses, regularly revised since 1896, may not provide guidance in an era of pandemic and sociopolitical unrest.
BACKGROUND
The ANA Code of Ethics for Nurses, regularly revised since 1896, may not provide guidance in an era of pandemic and sociopolitical unrest.
PURPOSE
This study explored whether the Code of Ethics comprehensively address current nursing challenges.
METHODS
23 nurses participated in six Zoom focus groups to discuss whether provisions were applicable to their current practice. An iterative approach was used to review transcripts independently and then merge findings to identify ethical themes.
FINDINGS
Provisions 4, 6, and 8 were most relevant. None of the provisions addressed the guilt secondary to isolating patients from support systems and not being "on the front lines" of COVID care.
DISCUSSION
The co-occurring crises of COVID-19 and social unrest created an ethical crisis for many nurses. The Code of Ethics provided a useful guide for framing discussion and formulating strategies for change, but did not eliminate distress during a time of novel challenges.
Topics: COVID-19; Codes of Ethics; Ethics, Nursing; Humans; Pandemics; SARS-CoV-2
PubMed: 34815004
DOI: 10.1016/j.apnr.2021.151508 -
Cold Spring Harbor Perspectives in... Oct 2019Bioelectronic medicine (BEM) offers exciting opportunities to treat diseases such as movement disorders and refractory inflammatory disease. The many variations of BEM... (Review)
Review
Bioelectronic medicine (BEM) offers exciting opportunities to treat diseases such as movement disorders and refractory inflammatory disease. The many variations of BEM allow for noninvasive aspects of treatment that might eliminate or reduce the need for pharmaceuticals; therefore, the term "electroceuticals" may be suitable. BEM has been effective for movement disorders and improvement of prosthetic devices. Based on this implication, there is an allowance to impact many focus areas that include but are not limited to autoimmune disease, sensory motor conditions, and neurological conditions. There are a wide array of ethical issues that relate to BEM, which include informed consent, research ethics, innovation, academic-industry relationships, intellectual property, and the conundrum that needs to be addressed when altering the brain such as the issues of autonomy and free beneficence and social justice. The major goal is to heighten awareness of ethical issues and facilitate a proactive ethical approach regarding BEM research.
Topics: Beneficence; Biotechnology; Electric Stimulation Therapy; Electronics, Medical; Ethics, Research; Humans; Organizational Culture; Social Justice
PubMed: 30478096
DOI: 10.1101/cshperspect.a034363 -
Journal of Genetic Counseling Oct 2020The field of genetic counseling has grown and diversified since the profession emerged in the early 1970s. In the same period, genomic testing has become more complex,...
The field of genetic counseling has grown and diversified since the profession emerged in the early 1970s. In the same period, genomic testing has become more complex, profitable, and widespread. With these developments, the scope of ethical considerations relevant to genetic counseling has expanded. In light of this, we find it helpful to revisit how ethical and relational variables are used to inform genetic counseling practice. Our specific focus is on whether, and to what extent, it is ethically acceptable for genetic counselors to make normative recommendations to patients. This article builds on prior literature that has critiqued nondirectiveness, a concept that has influenced and constrained the modern profession of genetic counseling since its origin. In it, we review scholarly efforts to move beyond nondirectiveness, which we believe privilege patient autonomy at the expense of other important values. We then argue that genetic counselors should favor a more explicit commitment to the principles of beneficence and non-maleficence, as well as a broader understanding of autonomy and the relational variables that impact genetic counseling. Finally, to translate our arguments into practice, we present a framework of six considerations that genetic counselors should take into account when deciding whether it is ethically acceptable, or even desirable, to make recommendations to patients in certain areas of their work.
Topics: Counselors; Ethics, Professional; Genetic Counseling; Genome, Human; Humans
PubMed: 31856388
DOI: 10.1002/jgc4.1207 -
Yearbook of Medical Informatics Aug 2020To provide an overview of recent work at the intersection of Biomedical Informatics, Human-Computer Interaction, and Ethics. (Review)
Review
OBJECTIVES
To provide an overview of recent work at the intersection of Biomedical Informatics, Human-Computer Interaction, and Ethics.
METHODS
Search terms for Human-Computer Interaction, Biomedical Informatics, and Ethics were used to identify relevant papers published between 2017 and 2019.Relevant papers were identified through multiple methods, including database searches, manual reviews of citations, recent publications, and special collections, as well as through peer recommendations. Identified articles were reviewed and organized into broad themes.
RESULTS
We identified relevant papers at the intersection of Biomedical Informatics, Human-Computer Interactions, and Ethics in over a dozen journals. The content of these papers was organized into three broad themes: ethical issues associated with systems in use, systems design, and responsible conduct of research.
CONCLUSIONS
The results of this overview demonstrate an active interest in exploring the ethical implications of Human-Computer Interaction concerns in Biomedical Informatics. Papers emphasizing ethical concerns associated with patient-facing tools, mobile devices, social media, privacy, inclusivity, and e-consent reflect the growing prominence of these topics in biomedical informatics research. New questions in these areas will likely continue to arise with the growth of precision medicine and citizen science.
Topics: Bioethical Issues; Biomedical Research; Computers; Health Records, Personal; Humans; Medical Informatics; Mobile Applications; User-Computer Interface
PubMed: 32823302
DOI: 10.1055/s-0040-1701990 -
Perfusion Mar 2024Early in 2022 the first pig to human cardiac xenotransplant was performed. The graft initially performed well, and rejection was well controlled. However, the graft... (Review)
Review
Early in 2022 the first pig to human cardiac xenotransplant was performed. The graft initially performed well, and rejection was well controlled. However, the graft failed, and the patient died 60 days after the procedure. The ethical issues relating to xenotransplantation include the risk/benefit to the individual, the risk of porcine-derived infectious agents crossing into humans, animal welfare and rights, issues of human and animal identity and concerns relating to fair allocation of organs and appropriate use of resources.These ethical issues are often addressed using emotional arguments, or through consequentialist or deontological lens. An alternative is to use approaches based on virtue ethics to understand the moral purpose () of the research and the virtues (character traits) needed to be a good research clinician. In this review we will consider the virtues of justice, courage, temperance and practical wisdom, as well as the role of clinical curiosity, and their application to xenotransplantation. This provides an alternative approach for the clinical academic and others involved in the research to reflect on their practice.
Topics: Humans; Animals; Swine; Virtues; Transplantation, Heterologous; Morals; Ethical Theory; Social Justice
PubMed: 36382884
DOI: 10.1177/02676591221140767 -
Indian Journal of Gastroenterology :... Feb 2021Publication of scientific paper is critical for modern science evolution, and professional advancement. However, it comes with many responsibilities. An author must be... (Review)
Review
Publication of scientific paper is critical for modern science evolution, and professional advancement. However, it comes with many responsibilities. An author must be aware of good publication practices. While refraining from scientific misconduct or research frauds, authors should adhere to Good Publication Practices (GPP). Publications which draw conclusions from manipulated or fabricated data could prove detrimental to society and health care research. Good science can blossom only when research is conducted and documented with complete honesty and ethics. Unfortunately, publish or perish attitude has led to unethical practices in scientific research and publications. There is need to identify, acknowledge, and generate awareness among junior researchers or postgraduate students to curb scientific misconduct and adopt GPP. This article discusses various unethical publication practices in research. Also, the role and responsibilities of authors have been discussed with the purpose of maintaining the credibility and objectivity of publication.
Topics: Authorship; Biomedical Research; Ethics, Research; Humans; Professional Role; Publishing; Scientific Misconduct
PubMed: 33481172
DOI: 10.1007/s12664-020-01129-5 -
Ugeskrift For Laeger Jun 2023This review describes the clinical ethics committees in Denmark. The clinical ethics committee is an interdisciplinary committee at a hospital intended to analyse... (Review)
Review
This review describes the clinical ethics committees in Denmark. The clinical ethics committee is an interdisciplinary committee at a hospital intended to analyse ethically challenging situations and burdensome choices in patient care. The work in Danish KEKs takes place without formal organisation, in contrast to several other countries, where clinical ethics is regulated by law as research ethics is in Denmark.
Topics: Humans; Ethics Committees, Clinical; Ethics, Research; Ethics Committees, Research
PubMed: 37325989
DOI: No ID Found -
Monash Bioethics Review Dec 2020Interactions between microbes and human hosts can lead to a wide variety of possible outcomes including benefits to the host, asymptomatic infection, disease (which... (Review)
Review
Interactions between microbes and human hosts can lead to a wide variety of possible outcomes including benefits to the host, asymptomatic infection, disease (which can be more or less severe), and/or death. Whether or not they themselves eventually develop disease, asymptomatic carriers can often transmit disease-causing pathogens to others. This phenomenon has a range of ethical implications for clinical medicine, public health, and infectious disease research. The implications of asymptomatic infection are especially significant in situations where, and/or to the extent that, the microbe in question is transmissible, potentially harmful, and/or untreatable. This article reviews the history and concept of asymptomatic infection, and relevant ethical issues associated with this phenomenon. It illustrates the role and ethical significance of asymptomatic infection in outbreaks, epidemics, and pandemics-including recent crises involving drug resistance, Zika, and Covid19. Serving as the Introduction to this Special Issue of Monash Bioethics Review, it also provides brief summaries of the other articles comprising this collection.
Topics: Asymptomatic Infections; Bioethical Issues; Epidemics; Ethics, Clinical; Ethics, Research; History, 19th Century; History, 20th Century; History, 21st Century; Humans; Public Health
PubMed: 33326062
DOI: 10.1007/s40592-020-00123-z