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BMC Medical Ethics

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https://www.readbyqxmd.com/read/28253882/principle-based-structured-case-discussions-do-they-foster-moral-competence-in-medical-students-a-pilot-study
#1
Orsolya Friedrich, Kay Hemmerling, Katja Kuehlmeyer, Stefanie Nörtemann, Martin Fischer, Georg Marckmann
BACKGROUND: Recent findings suggest that medical students' moral competence decreases throughout medical school. This pilot study gives preliminary insights into the effects of two educational interventions in ethics classes on moral competence among medical students in Munich, Germany. METHODS: Between 2012 and 2013, medical students were tested using Lind's Moral Competence Test (MCT) prior to and after completing different ethics classes. The experimental group (EG, N = 76) participated in principle-based structured case discussions (PBSCDs) and was compared with a control group with theory-based case discussions (TBCDs) (CG, N = 55)...
March 3, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28249603/the-importance-of-professional-values-from-clinical-nurses-perspective-in-hospitals-of-a-medical-university-in-iran
#2
Batool Poorchangizi, Jamileh Farokhzadian, Abbas Abbaszadeh, Moghaddameh Mirzaee, Fariba Borhani
BACKGROUND: Today, nurses are required to have knowledge and awareness concerning professional values as standards to provide safe and high-quality ethical care. Nurses' perspective on professional values affects decision-making and patient care. Therefore, the present study aimed to investigate the importance of professional values from clinical nurses' perspective. METHODS: The present cross-sectional study was conducted in 2016 in four educational hospitals of Kerman University of Medical Sciences, Iran...
March 1, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28249596/implicit-bias-in-healthcare-professionals-a-systematic-review
#3
Chloë FitzGerald, Samia Hurst
BACKGROUND: Implicit biases involve associations outside conscious awareness that lead to a negative evaluation of a person on the basis of irrelevant characteristics such as race or gender. This review examines the evidence that healthcare professionals display implicit biases towards patients. METHODS: PubMed, PsychINFO, PsychARTICLE and CINAHL were searched for peer-reviewed articles published between 1st March 2003 and 31st March 2013. Two reviewers assessed the eligibility of the identified papers based on precise content and quality criteria...
March 1, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28245820/unconventional-combinations-of-prospective-parents-ethical-challenges-faced-by-ivf-providers
#4
Robert Klitzman
BACKGROUND: Professional guidelines have addressed ethical dilemmas posed by a few types of nontraditional procreative arrangements (e.g., gamete donations between family members), but many questions arise regarding how providers view and make decisions about these and other such arrangements. METHODS: Thirty-seven ART providers and 10 patients were interviewed in-depth for approximately 1 h each. Interviews were systematically analyzed. RESULTS: Providers faced a range of challenges and ethical dilemmas concerning both the content and the process of decisions about requests for unconventional interfamilial and other reproductive combinations...
February 28, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28235413/presumed-consent-licenses-and-limits-inferred-from-the-case-of-geriatric-hip-fractures
#5
Joseph Bernstein, Drake LeBrun, Duncan MacCourt, Jaimo Ahn
BACKGROUND: Hip fractures are common and serious injuries in the geriatric population. Obtaining informed consent for surgery in geriatric patients can be difficult due to the high prevalence of comorbid cognitive impairment. Given that virtually all patients with hip fractures eventually undergo surgery, and given that delays in surgery are associated with increased mortality, we argue that there are select instances in which it may be ethically permissible, and indeed clinically preferable, to initiate surgical treatment in cognitively impaired patients under the doctrine of presumed consent...
February 24, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28231781/how-to-introduce-medical-ethics-at-the-bedside-factors-influencing-the-implementation-of-an-ethical-decision-making-model
#6
Barbara Meyer-Zehnder, Heidi Albisser Schleger, Sabine Tanner, Valentin Schnurrer, Deborah R Vogt, Stella Reiter-Theil, Hans Pargger
BACKGROUND: As the implementation of new approaches and procedures of medical ethics is as complex and resource-consuming as in other fields, strategies and activities must be carefully planned to use the available means and funds responsibly. Which facilitators and barriers influence the implementation of a medical ethics decision-making model in daily routine? Up to now, there has been little examination of these factors in this field. METHODS: A medical ethics decision-making model called METAP was introduced on three intensive care units and two geriatric wards...
February 23, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28228145/donation-after-brain-circulation-determination-of-death
#7
Anne L Dalle Ave, James L Bernat
BACKGROUND: The fundamental determinant of death in donation after circulatory determination of death is the cessation of brain circulation and function. We therefore propose the term donation after brain circulation determination of death [DBCDD]. RESULTS: In DBCDD, death is determined when the cessation of circulatory function is permanent but before it is irreversible, consistent with medical standards of death determination outside the context of organ donation...
February 23, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28219363/to-change-or-not-to-change-translating-and-culturally-adapting-the-paediatric-version-of-the-moral-distress-scale-revised-mds-r
#8
Margareta Af Sandeberg, Marika Wenemark, Cecilia Bartholdson, Kim Lützén, Pernilla Pergert
BACKGROUND: Paediatric cancer care poses ethically difficult situations that can lead to value conflicts about what is best for the child, possibly resulting in moral distress. Research on moral distress is lacking in paediatric cancer care in Sweden and most questionnaires are developed in English. The Moral Distress Scale-Revised (MDS-R) is a questionnaire that measures moral distress in specific situations; respondents are asked to indicate both the frequency and the level of disturbance when the situation arises...
February 20, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28212642/beyond-cultural-stereotyping-views-on-end-of-life-decision-making-among-religious-and-secular-persons-in-the-usa-germany-and-israel
#9
Mark Schweda, Silke Schicktanz, Aviad Raz, Anita Silvers
BACKGROUND: End-of-life decision making constitutes a major challenge for bioethical deliberation and political governance in modern democracies: On the one hand, it touches upon fundamental convictions about life, death, and the human condition. On the other, it is deeply rooted in religious traditions and historical experiences and thus shows great socio-cultural diversity. The bioethical discussion of such cultural issues oscillates between liberal individualism and cultural stereotyping...
February 17, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28202021/-i-passed-the-test-evidence-of-diagnostic-misconception-in-the-recruitment-of-population-controls-for-an-h3africa-genomic-study-in-cape-town-south-africa
#10
Francis Masiye, Bongani Mayosi, Jantina de Vries
BACKGROUND: Advances in genetic and genomic research have introduced challenges in obtaining informed consent for research in low and middle-income settings. However, there are only few studies that have explored challenges in obtaining informed consent in genetic and genomic research in Africa and none in South Africa. To start filling this gap, we conducted an empirical study to investigate the efficacy of informed consent procedures for an H3Africa genomic study on Rheumatic Heart Disease (RHDGen) at the University of Cape Town in South Africa...
February 15, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28178953/human-rights-violations-in-organ-procurement-practice-in-china
#11
Norbert W Paul, Arthur Caplan, Michael E Shapiro, Charl Els, Kirk C Allison, Huige Li
BACKGROUND: Over 90% of the organs transplanted in China before 2010 were procured from prisoners. Although Chinese officials announced in December 2014 that the country would completely cease using organs harvested from prisoners, no regulatory adjustments or changes in China's organ donation laws followed. As a result, the use of prisoner organs remains legal in China if consent is obtained. DISCUSSION: We have collected and analysed available evidence on human rights violations in the organ procurement practice in China...
February 8, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28166795/ethical-framework-for-the-detection-management-and-communication-of-incidental-findings-in-imaging-studies-building-on-an-interview-study-of-researchers-practices-and-perspectives
#12
Eline M Bunnik, Lisa van Bodegom, Wim Pinxten, Inez D de Beaufort, Meike W Vernooij
BACKGROUND: As thousands of healthy research participants are being included in small and large imaging studies, it is essential that dilemmas raised by the detection of incidental findings are adequately handled. Current ethical guidance indicates that pathways for dealing with incidental findings should be in place, but does not specify what such pathways should look like. Building on an interview study of researchers' practices and perspectives, we identified key considerations for the set-up of pathways for the detection, management and communication of incidental findings in imaging research...
February 6, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28166775/clinical-ethics-issues-in-hiv-care-in-canada-an-institutional-ethnographic-study
#13
Chris Kaposy, Nicole R Greenspan, Zack Marshall, Jill Allison, Shelley Marshall, Cynthia Kitson
BACKGROUND: This is a study involving three HIV clinics in the Canadian provinces of Newfoundland and Labrador, and Manitoba. We sought to identify ethical issues involving health care providers and clinic clients in these settings, and to gain an understanding of how different ethical issues are managed by these groups. METHODS: We used an institutional ethnographic method to investigate ethical issues in HIV clinics. Our researcher conducted in-depth semi-structured interviews, compiled participant observation notes, and studied health records in order to document ethical issues in the clinics, and to understand how health care providers and clinic clients manage and resolve these issues...
February 6, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28153006/regulation-of-genomic-and-biobanking-research-in-africa-a-content-analysis-of-ethics-guidelines-policies-and-procedures-from-22-african-countries
#14
Jantina de Vries, Syntia Nchangwi Munung, Alice Matimba, Sheryl McCurdy, Odile Ouwe Missi Oukem-Boyer, Ciara Staunton, Aminu Yakubu, Paulina Tindana
BACKGROUND: The introduction of genomics and biobanking methodologies to the African research context has also introduced novel ways of doing science, based on values of sharing and reuse of data and samples. This shift raises ethical challenges that need to be considered when research is reviewed by ethics committees, relating for instance to broad consent, the feedback of individual genetic findings, and regulation of secondary sample access and use. Yet existing ethics guidelines and regulations in Africa do not successfully regulate research based on sharing, causing confusion about what is allowed, where and when...
February 2, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28152998/critical-appraisal-of-advance-directives-given-by-patients-with-fatal-acute-stroke-an-observational-cohort-study
#15
A Alonso, D Dörr, K Szabo
BACKGROUND: Advance directives (AD) imply the promise of determining future medical treatment in case of decisional incapacity. However, clinical practice increasingly indicates that standardized ADs often fail to support patients' autonomy. To date, little data are available about the quality and impact of ADs on end-of-life decisions for incapacitated acute stroke patients. METHODS: We analyzed the ADs of patients with fatal stroke, focusing on: (a) their availability and type, (b) stated circumstances to which the AD should apply, and (c) stated wishes regarding specific treatment options...
February 2, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28148256/defining-reasonable-patient-standard-and-preference-for-shared-decision-making-among-patients-undergoing-anaesthesia-in-singapore
#16
J L J Yek, A K Y Lee, J A D Tan, G Y Lin, T Thamotharampillai, H R Abdullah
BACKGROUND: A cross-sectional study to ascertain what the Singapore population would regard as material risk in the anaesthesia consent-taking process and identify demographic factors that predict patient preferences in medical decision-making to tailor a more patient-centered informed consent. METHODS: A survey was performed involving patients 21 years old and above who attended the pre-operative evaluation clinic over a 1-month period in Singapore General Hospital...
February 2, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28129753/measuring-value-sensitivity-in-medicine
#17
Christian Ineichen, Markus Christen, Carmen Tanner
BACKGROUND: Value sensitivity - the ability to recognize value-related issues when they arise in practice - is an indispensable competence for medical practitioners to enter decision-making processes related to ethical questions. However, the psychological competence of value sensitivity is seldom an explicit subject in the training of medical professionals. In this contribution, we outline the traditional concept of moral sensitivity in medicine and its revised form conceptualized as value sensitivity and we propose an instrument that measures value sensitivity...
January 28, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28122615/dynamic-consent-a-potential-solution-to-some-of-the-challenges-of-modern-biomedical-research
#18
Isabelle Budin-Ljøsne, Harriet J A Teare, Jane Kaye, Stephan Beck, Heidi Beate Bentzen, Luciana Caenazzo, Clive Collett, Flavio D'Abramo, Heike Felzmann, Teresa Finlay, Muhammad Kassim Javaid, Erica Jones, Višnja Katić, Amy Simpson, Deborah Mascalzoni
BACKGROUND: Innovations in technology have contributed to rapid changes in the way that modern biomedical research is carried out. Researchers are increasingly required to endorse adaptive and flexible approaches to accommodate these innovations and comply with ethical, legal and regulatory requirements. This paper explores how Dynamic Consent may provide solutions to address challenges encountered when researchers invite individuals to participate in research and follow them up over time in a continuously changing environment...
January 25, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28114911/the-intention-to-disclose-medical-errors-among-doctors-in-a-referral-hospital-in-north-malaysia
#19
Arvinder-Singh Hs, Abdul Rashid
BACKGROUND: In this study, medical errors are defined as unintentional patient harm caused by a doctor's mistake. This topic, due to limited research, is poorly understood in Malaysia. The objective of this study was to determine the proportion of doctors intending to disclose medical errors, and their attitudes/perception pertaining to medical errors. METHODS: This cross-sectional study was conducted at a tertiary public hospital from July- December 2015 among 276 randomly selected doctors...
January 23, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28103849/-how-do-ethnic-minority-patients-experience-the-intercultural-care-encounter-in-hospitals-a-systematic-review-of-qualitative-research
#20
Liesbet Degrie, Chris Gastmans, Lieslot Mahieu, Bernadette Dierckx de Casterlé, Yvonne Denier
BACKGROUND: In our globalizing world, caregivers are increasingly being confronted with the challenges of providing intercultural healthcare, trying to find a dignified answer to the vulnerable situation of ethnic minority patients. Until now, international literature lacks insight in the intercultural care process as experienced by the ethnic minority patients themselves. We aim to fill this gap by analysing qualitative literature on the intercultural care encounter in the hospital setting, as experienced by ethnic minority patients...
January 19, 2017: BMC Medical Ethics
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