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Sante Publique (Vandoeuvre-les-Nancy,... 2022“Analytical frameworks” and “practical tools” referring extensively to values and principles have been developed since the 1990’s to...
CONTEXT
“Analytical frameworks” and “practical tools” referring extensively to values and principles have been developed since the 1990’s to provide guidance for public health decision makers and practitioners in ethical reasoning.
OBJECTIVE
This study aimed at identifying the values and principles in public health ethics “frameworks” and “tools”, at classifying them by theme, and at characterizing them by questioning their meanings and articulations.
METHOD
We conducted a systematic review according to PRISMA-S guidelines. It used 3 databases and gathered documents published during the last thirty years. This corpus was analyzed following a multidisciplinarily defined interpretive framework.
RESULTS
We included 51 publications. More than a half was issued by North American organizations and 7 by European organizations. We identified 110 values and 153 principles referring to the themes of justice, autonomy, beneficence and non-maleficence, governance and evaluation of actions.
LIMITATIONS
There are likely other unpublished frameworks and tools used by public health actors and decision makers.
CONCLUSION
Although the most cited values and principles appear to correspond to several fundamental characteristics of public health, it is still early to talk about an ethics specific to public health.
Topics: Beneficence; Humans; Public Health; Social Justice
PubMed: 36216630
DOI: No ID Found -
European Journal of Human Genetics :... Dec 2022Direct-to-consumer genetic testing (DTC-GT) is becoming increasingly widespread. The aim of this research was to systematically review the literature published on... (Review)
Review
Direct-to-consumer genetic testing (DTC-GT) is becoming increasingly widespread. The aim of this research was to systematically review the literature published on healthcare professionals' knowledge and views about DTC-GT, as an update to a 2012 systematic review. The secondary aim was to assess the knowledge and views of healthcare professionals on the ethical and legal issues pertaining to DTC-GT. A systematic search was performed to identify all relevant studies that have been conducted since 2012. Studies fulfilled the inclusion criteria if they were primary research papers conducted on healthcare professionals about their knowledge and views on health-related DTC-GT. PubMed, Embase, CINAHL, PsycINFO and Medline databases were searched from 2012 to May 2021. Title and abstract were screened, and full texts were reviewed by two study authors independently. New papers included were appraised and data were extracted on study characteristics, knowledge and views on DTC-GT, and ethical and legal issues. A narrative synthesis was conducted. Nineteen new papers were included, along with eight papers from the previous review. There was considerable variation in study participants with differing views, awareness levels, and levels of knowledge about DTC-GT. Genetic counsellors and clinical geneticists generally had more concerns, experience, and knowledge regarding DTC-GT. Ten ethical concerns and four legal concerns were identified. Healthcare professionals' knowledge and experience of DTC-GT, including awareness of DTC-GT ethical and legal concerns, have only minimally improved since the previous review. This emphasises the need for further medical learning opportunities to improve the gaps in knowledge amongst healthcare professionals about DTC-GT.
Topics: Humans; Delivery of Health Care; Direct-To-Consumer Screening and Testing; Genetic Testing; Health Personnel; Morals
PubMed: 36220915
DOI: 10.1038/s41431-022-01205-8 -
Journal of Empirical Research on Human... Jul 2023Informed consent and debriefing of research participants in studies that use deception are ethical safeguards for which existing scholarly work on their implementation... (Review)
Review
Informed consent and debriefing of research participants in studies that use deception are ethical safeguards for which existing scholarly work on their implementation remains variable and insufficiently clear. A systematic review of research ethics guidelines was conducted to sketch a picture of whether, why and how informed consent and debriefing are recommended when using deception. Documents roughly agreed on several general principles, but varied significantly in the specifics of why and whether these safeguards are necessary, in which conditions and how they should be implemented. Various aspects that appear in the literature could not be found in the guidelines. In our review, guidance was integrated and showed a variation of implementation strategies that could help in contextualizing these safeguards.
Topics: Humans; Informed Consent; Ethics, Research
PubMed: 37186795
DOI: 10.1177/15562646231173477 -
Journal of Cardiothoracic and Vascular... Feb 2022No systematic studies on retractions in cardiothoracic and vascular anesthesia exist. The aim of this analysis was to identify characteristics and trends of retractions...
OBJECTIVES
No systematic studies on retractions in cardiothoracic and vascular anesthesia exist. The aim of this analysis was to identify characteristics and trends of retractions in this field over the past three decades.
DESIGN
A search of the Retraction Watch Database for retracted articles published between 1990 and 2020 in the field of cardiothoracic and vascular anesthesia was performed.
SETTING
A bibliometric study.
PARTICIPANTS
Five thousand three hundred forty-four retractions with the term "medicine" in the subject code were selected. Retractions of full-length English articles reporting findings in cardiothoracic and vascular anesthesia were included.
INTERVENTIONS
None.
MEASUREMENTS AND MAIN RESULTS
A total of 63 articles published in 31 journals from January 1990 to August 2020 were retracted. The majority were original articles (n = 60, 95.2%) and retracted for scientific misconduct (n = 50, 79.4%). The percentage of retractions due to misconduct increased from 2010, with a spike in 2011 (n = 26/50, 52.0%), and reached a plateau in 2014. The three most common reasons for retraction were misconduct by the author (n = 31, 49.2%), duplication (n = 12, 19.0%), and errors within the manuscript (n = 11, 17.5%). The median time from publication to retraction was 4.3 years (IQR: 1.7-9.4) and decreased significantly over time (p < 0.001). The median impact factor (IF) of the journals that published retracted articles was 3.5 (IQR 2.0-4.5) and decreased significantly over the study period (p < 0.001).
CONCLUSION
Scientific misconduct represents the most common reason for retraction in cardiothoracic and vascular anesthesia. The median time to retraction and journal IF decreased significantly over time. While this is promising, future efforts should be made to screen for falsified data and standardize the processes after retraction to highlight problematic manuscripts.
Topics: Anesthesia; Anesthesiology; Bibliometrics; Biomedical Research; Databases, Factual; Humans; Scientific Misconduct
PubMed: 34600831
DOI: 10.1053/j.jvca.2021.09.005 -
Philosophy, Ethics, and Humanities in... Nov 2022Moral distress is one of the most important problems that nurses face in their care of patients. Various studies have reported the frequency and severity of moral... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Moral distress is one of the most important problems that nurses face in their care of patients. Various studies have reported the frequency and severity of moral distress in nurses. However, to date, a comprehensive study that shows the results of these research across the world was not found, therefore due to the importance of this issue, its role in the health of nurses and patients, and the lack of general statistics about it worldwide, the present study was conducted to determine the frequency and severity of moral distress in nurses through a systematic review and meta-analysis.
METHODS
In this review study, searching national and international databases of SID, MagIran, IranMedex, IranDoc, Google Scholar, Embase, ScienceDirect, Scopus, CINHAL, PubMed, and Web of Science (WoS) between 2005 and February 2020 were extracted. The random-effects model was used for analysis, and the heterogeneity of studies with the I index was investigated. Data were analyzed using Comprehensive Meta-Analysis (Version 2).
RESULTS
The frequency of moral distress in 9 articles with a sample size of 1576 persons was 1.7 ± 0.5 from (0-4), in 13 articles with a sample size of 1870 persons, 3.07 ± 0.1 from (0-5), in 6 articles with a sample size of 1316 persons, 3.2 ± 0.29 from (0-6), in 18 articles with a sample size of 1959 persons, 4.6 ± 0.518 from (1-7) and in 35 articles with a sample size of 3718 persons, 81.1 ± 4.6 from (216-30), and the severity of moral distress in 4 articles with a sample size of 1116 persons, 1.7 ± 0.37 from (0-4), in 5 articles with a sample size of 1282 persons, 2.6 ± 0.28 from (0-5), in 5 articles with a sample size of 944 persons, 3.9 ± 0.63 from (0-6) and in 8 articles with a sample size of 901 persons was 82.3 ± 5.4 (0-216).
CONCLUSION
The results of this study showed that the frequency and severity of moral distress in nurses are high and are a serious problem in nurses. Therefore, policymakers in this field should consider its role in the health of nurses and patients.
Topics: Humans; Morals
PubMed: 36348378
DOI: 10.1186/s13010-022-00126-0 -
Psychiatria Polska Jun 2019The article was written with the intention of filling the gap in the Polish psychiatric literature, which has not yet found room for the analysis of the phenomenon of...
The article was written with the intention of filling the gap in the Polish psychiatric literature, which has not yet found room for the analysis of the phenomenon of bipolar disorder (BD) in terms of consequences that it may have for identity of people diagnosed with it. In order to do that, taking into account absence of the research in Poland, an attempt was made to find all previous reports on this subject in English-language professional journals and monographs. As a result, a detailed description with commentaries was made on five thorough studies of essentially qualitative nature. Although the .identity' was operationalized a little differently in each of them, it addressed each time the question: "Who am I?", both in phenomenological terms, most often manifested in the loss of a sense of continuity, and cognitive terms, associated with the key elements of self-image. The presented studies revealed a number of threats to identity, more or less specific for BD. The nature of these studies does not allow the generalization of their results, nor answer the question of a scale of the phenomenon. On the other hand, the relative similarity of these results reveals previously overlooked difficulties, potentially frequent and important to more holistic understanding and therapy of people with BD, for which the implications have been summarized in the final part of the text.
Topics: Bipolar Disorder; Female; Humans; Male; Personal Autonomy; Poland; Quality of Life; Self Concept; Self-Management
PubMed: 31522206
DOI: 10.12740/PP/92014 -
Annals of Plastic Surgery Apr 2014Maintenance of the highest ethical and professional standards in plastic surgery is in the best interests of our profession and the public whom we serve. Both the... (Review)
Review
BACKGROUND
Maintenance of the highest ethical and professional standards in plastic surgery is in the best interests of our profession and the public whom we serve. Both the American Board of Medical Specialties and the Accreditation Council on Graduate Medical Education mandate training in ethics and professionalism for all residents. Presently there is no gold standard in ethics and professionalism education.
METHODS
A systematic review on teaching ethics and professionalism in plastic surgery was performed for all articles from inception to May 23, 2013 in MEDLINE, Scopus, EMBASE, CENTRAL, and ERIC. References of relevant publications were searched for additional papers. Key journals were hand searched and relevant conference proceedings were also reviewed. Duplicate and non-English articles were excluded. Inclusion and exclusion criteria were applied to find articles that described a curriculum in ethics and/or professionalism in plastic surgery.
RESULTS
Two hundred twenty-seven relevant articles were identified. One hundred seventy-four did not meet inclusion criteria based on screening of the title, and 39 of those did not meet inclusion criteria based on screening of the abstract or introductory paragraph. Of the 14 identified for full text review, only 2 articles described a set curriculum in ethics and/or professionalism in plastic surgery training and reported outcomes.
CONCLUSIONS
A paucity of data exists regarding the structure, content, or relevant measures that can be applied to assess outcomes of a curriculum to teach ethics and professionalism to plastic surgery trainees. Endeavors to teach ethics and professionalism to plastic surgery trainees must rigorously document the process and outcomes to facilitate the maintenance of our profession.
Topics: Curriculum; Education, Medical, Graduate; Ethics, Medical; Humans; Internship and Residency; Surgery, Plastic; United States
PubMed: 24618742
DOI: 10.1097/SAP.0000000000000126 -
Transplantation Sep 2013The deceased-donor organ shortage has driven widespread adoption of living-donor transplantation. Yet, public views on living donation are not well understood. This... (Review)
Review
BACKGROUND
The deceased-donor organ shortage has driven widespread adoption of living-donor transplantation. Yet, public views on living donation are not well understood. This study aims to synthesize studies on public awareness and attitudes toward living organ donation.
METHODS
Electronic databases and reference lists were searched to September 2012. Summary estimates from survey data were obtained by random effects meta-analysis. Qualitative descriptive synthesis of each study was performed.
RESULTS
Forty-seven studies involving 34,610 respondents were included. The proportion of respondents aware of living organ donation was 76.7% (4 studies, n=3248; 95% confidence interval, 46.2%-97.0%; I=99.7%). The majority were in favor of living directed donation (85.5% (11 studies, n=15,836; 95% confidence interval, 81.6%-89.6%; I=98%), with recipient and community benefit as the rationale provided. However, barriers included fear of surgical and health risks, lack of knowledge, respect for cultural norms, financial loss, distrust in hospitals, and avoiding recipient indebtedness. The public voiced concern about possible risks or an obligatory pressure exerted on the donor. Many supported reimbursement for out-of-pocket expenses, paid leave, wait-listing priority, health insurance, and donor acknowledgment. There was strong opposition to financial incentives, which they believed risked exploitation and inequity and diminished voluntary altruistic donation.
CONCLUSIONS
The public is generally supportive of living donation and articulated important equity and ethical considerations for protecting the health and safety of living donors. This supports increased public engagement and strengthening of a shared view among professionals and the public in living donation practice and policy.
Topics: Awareness; Health Knowledge, Attitudes, Practice; Humans; Living Donors; Personal Autonomy; Tissue and Organ Procurement
PubMed: 23677051
DOI: 10.1097/TP.0b013e31829282ac -
Neuroscience and Biobehavioral Reviews Dec 2016This systematic review aimed to provide a comprehensive summary of the current literature on the neurobiological underpinnings of the experience of the negative moral... (Review)
Review
This systematic review aimed to provide a comprehensive summary of the current literature on the neurobiological underpinnings of the experience of the negative moral emotions: shame, embarrassment and guilt. PsycINFO, PubMed and MEDLINE were used to identify existing studies. Twenty-one functional and structural magnetic resonance imaging and positron emission tomography studies were reviewed. Although studies differed considerably in methodology, their findings highlight both shared and distinct patterns of brain structure/function associated with these emotions. Shame was more likely to be associated with activity in the dorsolateral prefrontal cortex, posterior cingulate cortex and sensorimotor cortex; embarrassment was more likely to be associated with activity in the ventrolateral prefrontal cortex and amygdala; guilt was more likely to be associated with activity in ventral anterior cingulate cortex, posterior temporal regions and the precuneus. Although results point to some common and some distinct neural underpinnings of these emotions, further research is required to replicate findings.
Topics: Anger; Guilt; Humans; Magnetic Resonance Imaging; Morals; Shame
PubMed: 27687818
DOI: 10.1016/j.neubiorev.2016.09.019 -
The British Journal of Psychiatry : the... Jun 2018Many people confront potentially morally injurious experiences (PMIEs) in the course of their work which can violate deeply held moral values or beliefs, putting them at... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Many people confront potentially morally injurious experiences (PMIEs) in the course of their work which can violate deeply held moral values or beliefs, putting them at risk for psychological difficulties (e.g. post-traumatic stress disorder (PTSD), depression, etc.).AimsWe aimed to assess the effect of moral injury on mental health outcomes.
METHOD
We conducted a systematic review and meta-analysis to assess the association between work-related PMIEs and mental health disorders. Studies were independently assessed for methodological quality and potential moderator variables, including participant age, gender and PMIE factors, were also examined.
RESULTS
Thirteen studies were included, representing 6373 participants. PMIEs accounted for 9.4% of the variance in PTSD, 5.2% of the variance in depression and 2.0% of the variance in suicidality. PMIEs were associated with more symptoms of anxiety and behavioural problems (e.g. hostility), although this relationship was not consistently significant. Moderator analyses indicated that methodological factors (e.g. PMIE measurement tool), demographic characteristics and PMIE variables (e.g. military v. non-military context) did not affect the association between a PMIE and mental health outcomes.
CONCLUSIONS
Most studies examined occupational PMIEs in military samples and additional studies investigating the effect of PMIEs on civilians are needed. Given the limited number of high-quality studies available, only tentative conclusions about the association between exposure to PMIEs and mental health disorders can be made.Declaration of interestNone.
Topics: Depressive Disorder; Humans; Military Personnel; Morals; Occupational Diseases; Stress Disorders, Post-Traumatic; Suicide
PubMed: 29786495
DOI: 10.1192/bjp.2018.55