Biomedical Ethics

Edited by L. Syd M Johnson (SUNY Upstate Medical University)
Assistant editor: Tyler John (Longview Philanthropy)
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History/traditions: Biomedical Ethics

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  1. Evolving Capacity of Children and Their Best Interests in the Context of Health Research in South Africa: An Ethico‐Legal Position.Melodie Labuschaigne, Safia Mahomed & Ames Dhai - forthcoming - Developing World Bioethics.
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  2. Using Antipsychotics for Self-Defense Purposes by Care Staff in Residential Aged Care Facilities: An Ethical Analysis.Hojjat Soofi - 2022 - Cambridge Quarterly of Healthcare Ethics 31 (4):487 - 495.
    People with dementia at times exhibit threatening and physically aggressive behavior toward care staff in residential aged care facilities (RACFs). Current clinical guidelines recommend judicious use of antipsychotic (AP) medications when there is an immediate risk of harm to care staff in RACFs and non-pharmacological interventions have failed to avert the threats. This article examines an account of how this recommendation can be ethically defensible: caregivers in RACFs may have a prima facie ethical justification, in certain cases, to use APs (...)
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  3. Dignity, Conscience and Religious Pluralism in Healthcare: An Argument for a Presumption in Favour of Respect for Religious Belief.David Kirchhoffer - 2022 - Bioethics.
    Abstract Religious pluralism in healthcare means that conflicts regarding appropriate treatment can occur because of convictions of patients and healthcare workers alike. This contribution argues for a presumption in favour of respect for religious belief on the basis that such convictions are judgements of conscience, and respect for conscience is core to what it means to respect human dignity. The human person is a subject in relation to all that is. Human dignity refers to the worth of human persons as (...)
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  4. Editorial Note.Rebecca Kukla - 2015 - Kennedy Institute of Ethics Journal 25 (1):ix-x.
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  5. Editorial Note.Rebecca Kukla - 2014 - Kennedy Institute of Ethics Journal 24 (4):vii-ix.
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  6. The Plurality of Chinese and American Medical Moralities: Toward an Interpretive Cross-Cultural Bioethics.Nie Jing-Bao - 2000 - Kennedy Institute of Ethics Journal 10 (3):239-260.
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  7. Ethical Challenges in Clinical Studies with Adaptive Design in Oncology.Norbert W. Paul & Hamideh Mahdiani - forthcoming - Clinical Ethics.
    Novel immune therapies are increasingly based on the molecular differentiation of disease patterns. The related clinical studies are thus more often characterized by the so-called adaptive study designs, which are continuously adjusted based on novel results. This paper analyses new study designs beyond the often-postulated need for regulation in order to identify ethical problems based on typical structural features and to—whenever possible—suggest solutions. To do so, it addresses the following topics: the relationship between social and scientific values of a study (...)
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  8. Ethical Reflections on How Health Professionals Should Answer the Question: What Would You Do If This Were Your Family Member?Atsushi Asai, Miki Fukuyama & Motoki Ohnishi - forthcoming - Clinical Ethics.
    Patient families sometimes ask health professionals, ‘What would you do if this were your family member?’ The purpose of this paper is to examine appropriate responses to this Question. Health professionals may say, ‘It all depends on the patient's wishes’, or ‘I don't know what is best, because my family is different from yours in many ways’. Some may believe that the most favourable course of action is the same regardless of who the patient is and explain this to the (...)
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  9. Some Desiderata for a Taxonomy of Conscientious Objection in Health Care: A Reply to Gamble and Saad.Michael Robinson & Jeffrey Byrnes - forthcoming - Clinical Ethics.
    In a recent issue of this journal, Gamble and Saad offer a taxonomy of conscientious objection in health care with the aim of increasing the common ground in the debate over conscientious objection to prevent parties from talking past each other and help facilitate greater progress on this issue. Although we agree that this is an important and worthwhile project, Gamble and Saad's proposal suffers from several serious weaknesses that limit its ability to do the work set out for it. (...)
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  10. Bioethics After the COVID-19 Pandemic: More Research, Fewer Committees?Henri-Corto Stoeklé & Christian Hervé - 2022 - Clinical Ethics 17 (4):327-330.
    In the face of the pandemic, bioethics, once again, proved its scientific utility. In France, in particular, the academic approach should be given priority over the institutional approach, in hospitals, research institutes, universities, and companies, with the professionalization that this would imply.
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  11. On Challenges to Respect for Autonomous Decision Making in Primary Care.John Spicer, Sanjiv Ahluwalia & Rupal Shah - 2022 - Clinical Ethics 17 (4):458-464.
    Primary health care is characterised by timely and appropriate health care access, delivered continuously over time to a specific population, providing a comprehensive service, with coordination of care for those that need it. Practitioners deal with a multiplicity of clinical issues within longitudinal relationships, embedded in the context of families and communities. We propose that these aspects of primary care have a bearing on how matters of decision making are considered and implemented. Further, the standard account of autonomous decision making (...)
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  12. Bedside Rationing in Cancer Care: Patient Advocate Perspective.Ornella Gonzato - 2022 - Clinical Ethics 17 (4):358-362.
    Rationing in healthcare remains very much a taboo topic. Before COVID-19, it rarely received public attention, even when it occurred in everyday practices, mainly in the form of implicit rationing, as it continues to do today. There are different definitions, types and levels of healthcare rationing, according to different perspectives. With the aim of contributing to a more coherent debate on such a highly emotional healthcare issue as rationing, here are provided a number of reflections from a patient advocate perspective (...)
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  13. Rethinking Individual Autonomy in Medical Decision-Making for Young Adults Reliant on Caregiver Support: A Case Report and Analysis.Alexia Zagouras, Elise Ellick & Mark Aulisio - 2022 - Clinical Ethics 17 (4):452-457.
    There is a gap in the clinical bioethics literature concerning the approach to assessment of medical decision-making capacity of adolescents or young adults who demonstrate diminished maturity due to longstanding reliance on caregiver support, despite having reached the age of majority. This paper attempts to address this question via the examination of a particular case involving assessment of the decision-making capacity of a young adult pregnant patient who also had a physically disabling neurological condition. Drawing on concepts from adolescent bioethics (...)
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  14. Medical Students Positions Regarding Resource Allocation in Times of Crisis.Daniel Minkin Levy, Iftach Sagy, Margaret Johansson Lipinski Lubianiker & Alan Jotkowitz - 2022 - Clinical Ethics 17 (4):432-441.
    Objective To compare the perspectives of medical students in the preclinical and clinical phases of medical training on the issue of rationing scarce medical resources in times of crisis. Methods Questionnaire-based cross-sectional study. Results A total of 201 participants took part in the study, with 100 participants in the preclinical phase group, and 101 in the clinical phase group. A multivariable analysis found that just 14.9% of the clinical phase students were willing to give a short-supplied blood unit to the (...)
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  15. Ethical Problems in the Nurses Action in the Beginning of Life.Sandra Paço & Sérgio Deodato - forthcoming - Clinical Ethics.
    Introduction The act of caring in nursing requires previous deliberation and decision, however this perception only arises when an ethical problem emerges. Objective: Identify ethical problems of nurses action in the area of beginning of human life Method: Exploratory and descriptive method, with a qualitative approach. Semi-structured interviews were used to collect data, who were submitted to content analysis. The sample was constituted by 26 nurses. Results 18 categories of problem areas and 56 ethical problems in early human life were (...)
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  16. Ethics of Care and Moral Resilience in Health Care Practice: A Scoping Review.Sharon Selvakumar & Belinda Kenny - forthcoming - Clinical Ethics.
    Background Ethics of care provides a framework for health care professionals to manage ethical dilemmas and moral resilience may mitigate stress associated with the process and outcomes of ethical reasoning. This review addresses the empirical study of ethics of care and moral resilience, published in the health care literature, and identifies potential research gaps. Methods and procedure Arksey O’Malley's framework was adopted to conduct this scoping review. A literature search was conducted across six databases: CINAHL Plus with full text, PubMed, (...)
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  17. The Ethical and Medico-Legal Challenges of Telemedicine in the Coronavirus Disease 2019 Era: A Comparison Between Egypt and India.Sara A. Ghitani, Maha A. Ghanem, Hanaa S. Alhoshy, Jaskran Singh, Supriya Awasthi & Ekampreet Kaur - forthcoming - Clinical Ethics.
    Background In the coronavirus disease 2019 era, doctors have tried to decrease hospital visits and admissions. To this end, telemedicine was implemented in a non-systematic manner according. The objective of this study was to assess the current knowledge and attitudes of physicians in Alexandria, Egypt, and Punjab, India, toward telemedicine and its ethical and medico-legal issues. Method A cross-sectional study was implemented using an anonymous self-administered questionnaire carried out over two months. A four-point Likert scale was used to collect data (...)
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  18. Sunshine Act in the Dark.Kiya Shazadeh Safavi, Angelina Hong, Cory F. Janney, Vinod K. Panchbhavi & Daniel C. Jupiter - 2022 - Clinical Ethics 17 (2):122-129.
    Background This study assessed patient perceptions of the Physician Payments Sunshine Act and opinions toward physicians who receive gifts and/or payments from pharmaceutical or medical device companies. Methods During their office visit, patients attending different specialty clinics volunteered to complete our survey. The survey asks if the patient knows what the Sunshine Act is, then asks questions on 5-point response scales to assess the patient's opinions toward physicians who receive compensation from companies, their self-rated knowledge of physician compensation, and how (...)
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  19. Fostering Medical Staff Reflection on the Technological Alienation of Parents in the NICU.Abram Brummett & Annie B. Friedrich - 2022 - Clinical Ethics 17 (4):449-451.
    We describe a case of parents refusing a tracheostomy for an otherwise healthy newborn. The refusal was not honored because permitting the refusal would have violated state law, which required a child to have a qualifying condition to remove or withhold life-sustaining treatment. However, this case strained the relationship between the parents and medical staff, who worried about sending the newborn home with a tracheostomy where she was not wanted. While many ethical issues arise in treatment refusal cases like this, (...)
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  20. The Case for Compulsory Surgical Smoke Evacuation Systems in the Operating Theatre.Daniel Rodger - 2022 - Clinical Ethics 17 (2):130-135.
    Perioperative staff are frequently exposed to surgical smoke or plume created by using heat-generating devices like diathermy and lasers. This is a concern due to mounting evidence that this exposure can be harmful with no safe level of exposure yet identified. First, I briefly summarise the problem posed by surgical smoke exposure and highlight that many healthcare organisations are not sufficiently satisfying their legal and ethical responsibilities to protect their staff from potential harm. Second, I explore the ethical case for (...)
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  21. The Care of the Self as a Moral Foundation of Physiotherapy.Krzysztof Pezdek - forthcoming - Clinical Ethics.
    The aim of this paper is to offer theoretical insights into the care of the self, which often initiates therapist-patient relationships in clinical practice. The reason is that when patients care about their health status, they are inclined to establish a therapeutic relationship with physical therapists. Hence, the care for self may bridge the world of the patient's private experiences and the world of the healthcare system together with its interventions, which is represented by the physical therapist In this framework, (...)
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  22. Preventing Moral Conflicts in Patient Care: Insights From a Mixed-Methods Study with Clinical Experts.Jan Schürmann, Gabriele Vaitaityte & Stella Reiter-Theil - forthcoming - Clinical Ethics.
    Background and aim Healthcare professionals are regularly exposed to moral challenges in patient care potentially compromising quality of care and safety of patients. Preventive clinical ethics support aims to identify and address moral problems in patient care at an early stage of their development. This study investigates the occurrence, risk factors, early indicators, decision parameters, consequences and preventive measures of moral problems. Method Semi-structured expert interviews were conducted with 20 interprofessional healthcare professionals from 2 university hospitals in Basel, Switzerland. A (...)
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  23. The Relationship Between Ethical Climate and Moral Distress From the Perspective of Operating Room Staff: A Correlational Study.Fatemeh Esmaelzadeh, Fatemeh Rajabdizavandi & Monirsadat Nematollahi - forthcoming - Clinical Ethics.
    Background The organizational climate in the operating room is special due to the specific conditions of the patient, and the ethical climate may affect moral distress of the operating room staff. Objective This study determined the relationship between ethical climate and moral distress from staff working in operating rooms of hospitals affiliated to Mashhad University of Medical Sciences. Method This analytical study was performed on 169 operating room staff in Mashhad, Iran. The operating room staff was selected using stratified random (...)
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  24. Unbefriended, Uninvited: How End-of-Life Doulas Can Address Ethical and Procedural Gaps for Unrepresented Patients and Ensure Equal Access to the “Good Death”.Adele Flaherty & Anna Meurer - forthcoming - Clinical Ethics.
    In response to a global population with increasingly complex issues at the end of life, a movement in the U.S. has emerged incorporating doulas into end-of-life care. These end-of-life doulas are not just focused on the quality of life, but also the quality of death. Like birth doulas, who provide support for pregnant patients and their families, EOL doulas help alleviate physical and mental discomfort in those who are dying. In this paper, we explore the role of EOL doulas in (...)
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  25. ‘At Least I Have Done Something’: A Qualitative Study of Women's Social Egg Freezing Experiences.Michiel De Proost, Gily Coene, Julie Nekkebroeck & Veerle Provoost - 2022 - Clinical Ethics 17 (4):425-431.
    Social egg freezing has become an expanding clinical practice and there is a growing body of empirical literature on women's attitudes and the sociocultural implications of this phenomenon. Yet, its impact remains subject to ethical controversy. This article reports on a qualitative study, drawing on 18 interviews with women who had elected to initiate at least one egg freezing cycle in Belgium. Our findings, facilitated by a ‘symbiotic empirical ethics’ approach, shed light on the concerns and perceptions that accompany women's (...)
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  26. A Critical Review Analysis of the Issues Arising Out of the Clinical Practice by an Infected Health Care Worker.Raghvendra K. Vidua, Nisha Dubey, Punit Kumar Agarwal, Daideepya C. Bhargava & Parthasarathi Pramanik - 2022 - Clinical Ethics 17 (2):113-117.
    The way communicable diseases do spread from one person to another, depending upon the specific disease or causative infectious agent. Out of these diseases, some are incurable and the health care workers during their practice or otherwise acquire such infections and transmit them further to innocent patients who are unaware of about the health status of health care workers. The rights of an infected health care worker and patients are protected by many laws but in case of conflict of interests (...)
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  27. Association Between Moral Intelligence, Burnout and Quality of Nursing Care.Tahereh Heidari, Hamideh Azimilolaty, Majid Khorram, Soraya Rezaei, Seyed-Nouraddin Mousavinasab & Roya Nikbakht - 2022 - Clinical Ethics 17 (4):334-345.
    Background Providing quality care is of the fundamental elements of holistic nursing practice, and burnout and moral intelligence of nurses be mentioned as the important factors influencing the quality of nursing care. The present study was conducted to investigate the relationship between moral intelligence, burnout, and the quality of nursing care. Methods This descriptive-correlative study was conducted on 125 nurses working in Sari-based Educational hospitals affiliated to Mazandaran University of Medical Sciences, Iran, between June and August 2020. The sample was (...)
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  28. Protecting Nurse Survey Participants: Ethical Considerations for Conducting Survey Research Among Nurses.Caitlin M. Campbell, Tanekkia Taylor-Clark & Lori A. Loan - 2022 - Clinical Ethics 17 (4):391-408.
    The nurse perspective is critical in survey research investigating various aspects of healthcare services, staff, and patient outcomes. Researchers are responsible for ensuring that survey research utilizing survey questionnaires employs research methodological strategies that are aligned with the ethical principles of beneficence, respect for persons, and justice. The purpose of this paper is to discuss best practices to facilitate high-quality survey data collection for nurse survey participants. Recommendations are based on the fundamental ethical principles described in the Belmont Report, an (...)
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  29. What Are the Ethical Conflicts Faced by Mexican Internists?Octavio Márquez Mendoza, José de Jesús Garduño García, Marcela Veytia López, Jorge Rodríguez García, Rosalía García Peña & Benjamin Herreros - 2022 - Clinical Ethics 17 (4):409-414.
    Background No studies have been conducted in Mexico to ascertain what ethical problems doctors working at hospitals deal with. This article aims to describe the ethical conflicts most commonly identified by Mexican internists and the importance they attribute to each of these conflicts. Methods Voluntary survey to the members of the Internal Medicine Association of Mexico. Results Responses were submitted by 347 internists. Half of those face ethical conflicts almost always or frequently. The most commonplace and relevant conflicts are those (...)
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  30. Psychiatrists’ Motives for Compulsory Care of Patients with Borderline Personality Disorder – a Questionnaire Study.Antoinette Lundahl, Johan Hellqvist, Gert Helgesson & Niklas Juth - 2022 - Clinical Ethics 17 (4):377-390.
    Introduction Borderline personality disorder patients are often subjected to inpatient compulsory care due to suicidal behaviour. However, inpatient care is usually advised against as it can have detrimental effects, including increased suicidality. Aim To investigate what motives psychiatrists have for treating borderline personality disorder patients under compulsory care. Materials and Methods A questionnaire survey was distributed to all psychiatrists and registrars in psychiatry working at mental health emergency units or inpatient wards in Sweden. The questionnaire contained questions with fixed response (...)
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  31. Ethical Considerations and Clinical Trials During a Pandemic: A Blessing with a Burden.Madhan Ramesh, Jehath Syed & Chalasani Sri Harsha - 2022 - Clinical Ethics 17 (4):331-333.
    Any healthcare systems during a pandemic undergo tremendous pressure in pursuit of effective treatment to treat and limit the spread of the disease and its implications. Conducting clinical trials to find the potential therapy is the only way to battle the current coronavirus disease-2019 pandemic. The majority of the countries have joined the cause and are carrying out clinical studies in various capacities. As a result, the ethical committees have encountered a sudden inflow of a large number of trial proposals (...)
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  32. ‘Who Ya Gonna Call …?’ Ethical and Legal Dilemmas in Specialist Children Centres and District General Hospitals.Harika Avula, Mariana Dittborn & Joe Brierley - 2022 - Clinical Ethics 17 (4):415-424.
    The field of Paediatric Bioethics, or ethical issues applied to children's healthcare, is relatively new but has recently gained an increased professional and public profile. Clinical ethics support to health professionals and patients who face ethical challenges in clinical practice varies between and within institutions. Literature regarding services available to paediatricians is sparse in specialist tertiary centres and almost absent in general paediatrics. We performed a mixed-methods study using online surveys and focus groups to explore the experiences of ethical and (...)
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  33. Does the Light at the End of the Tunnel Shine for Everyone? The Need for Early Paediatric Participation in Vaccine Trials During Infectious Pandemics.Erin M. Kwolek - 2022 - Clinical Ethics 17 (4):346-351.
    While most of the mortality associated with severe acute respiratory syndrome coronavirus 2 has been in elderly populations and adults with significant medical comorbidities, there has been death and morbidity in paediatric populations. As vaccine trial data is released to the public, many people look to the future with hope ; with good vaccine uptake there is the opportunity to reduce the spread of infectious pandemics. Initial vaccine trials were completed with adults and were expanded to include paediatric populations delaying (...)
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  34. A “Talent Agency” Refers Children for Research: A Case Study.David C. Schwebel, Anna Johnston & Leslie A. McClure - 2022 - Clinical Ethics 17 (2):217-219.
    Objective Ethical standards state research participation must be voluntary and free of coercion and undue influence, but what if a third party appears to engage in research-relevant coercion, without the researchers’ knowledge? This case study describes this type of situation and its resolution. Methods We are engaged in a randomized clinical trial evaluating pedestrian safety with 7- and 8- years old. Depending on children's rate of learning, families receive up to $1275 for their time. We recently learned a third-party “talent (...)
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  35. Comparison of Ethical Decision-Making and Interpersonal Communication Skills Training Effects on Nurses’ Ethical Climate.Shahrokh Maghsoudi, Mohaddeseh Mohsenpour & Hamed Nazif - 2022 - Clinical Ethics 17 (2):184-190.
    Introduction Ethical climate in medical contexts is referred to the organizational environment consisting of medical staff interpersonal relationships regarding patient care. This element affects staff behavior in an organization. The investigation and comparison of the effects of the interventions promoting ethical climate are among important nursing challenges that should be considered by researchers. The present study was conducted to compare the effect of nurses’ ethical decision-making skills and interpersonal communication training on their ethical climate. Materials and methods This experimental study (...)
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  36. Shared Decision-Making in Patient–Doctor Consultations – How Does It Relate to Other Patient-Centred Aspects and Satisfaction?Helene Bodegård, Gert Helgesson, Daniel Olsson, Niklas Juth & Niels Lynøe - 2022 - Clinical Ethics 17 (2):152-160.
    Background This study was designed to investigate how patient-reported shared decision-making relates to other aspects of patient centredness and satisfaction. Methods Questionnaire study with patients. Consecutive patients in primary care responding post visit. Associations are presented as proportions, positive predictive values, with 95% confidence intervals. Results 223 patient questionnaires were included. 62% : 55–69) of the patients indicated the highest possible rating of being involved in the decisions about their ongoing care. Self-reported SDM had a positive predictive value of between (...)
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  37. Diminished Autonomy and Justice in Liver Transplantation – The Price of Scarcity?Philip Berry & Sreelakshmi Kotha - 2021 - Clinical Ethics 16 (4):291-297.
    Patient autonomy and distributive justice are fundamental ethical principles that may be at risk in liver transplant units where decisions are dictated by the need to maximise the utility of scarce donor organs. The processes of patient selection, organ allocation and prioritisation on the wait list have evolved in a constrained environment, leading to high levels of complexity and low transparency. Regarding paternalism, opaque listing and allocation criteria, patient factors such as passivity, guilt, chronic illness and sub-clinical encephalopathy are cited (...)
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  38. The Effect of Professional Ethics Workshop with Virtual Follow-Up on Nurses Moral Distress.Ali Ghahremani, Fatemeh Esmaelzadeh, Mahboobeh Khosravani & Mohaddeseh Mohsenpour - 2022 - Clinical Ethics 17 (2):191-197.
    Research objectives Moral distress is a common phenomenon among nurses and can negatively affect their mental health and quality of the care. This study aimed to determine the effect of professional ethics workshop with virtual follow-up on the moral distress of nurses. Methods This experimental study was performed on 50 nurses in Ghaem Hospital, Mashhad, Iran. The intervention group received 8-hour professional ethics workshop and 4 weeks follow-up through social network. The moral distress was evaluated through the Moral Distress Scale-Revised (...)
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  39. The Role of Emotions in Moral Case Deliberation: Visions and Experiences of Facilitators.Benita Spronk, Guy Widdershoven & Hans Alma - 2022 - Clinical Ethics 17 (2):161-171.
    Moral Case Deliberation is intended to assist healthcare professionals faced with difficult dilemmas in their work. These are situations that involve emotions. During Moral Case Deliberation, participants are invited to reflect on moral views and deliberate on them. Emotions are not explicitly addressed. This article aims to elucidate the role of emotions in Moral Case Deliberation, by analysing experiences of Moral Case Deliberation facilitators. Our research shows the role of emotions varies according to the phase of the Moral Case Deliberation (...)
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  40. Development and Validation of the Ethical Challenges in Clinical Situations-Questionnaire (ECCS-Q) by Involving Health-Care Providers From a Tertiary Care Health Setting.Snehil Gupta, Swarndeep Singh, Siddharth Sarkar & Atul Batra - 2022 - Clinical Ethics 17 (2):172-183.
    Background and rationale Clinicians often encounter a variety of ethical challenges in their routine clinical practice, and it varies across healthcare and cultural settings of their practice. Despite of this, there are no clear-cut available guidelines concerning the right course of action in a given ethically challenging situation. A validated instrument that could capture the health care providers’ viewpoints in this regard is lacking from Indian settings. Thus, the current study aimed at developing an instrument to assess the HCP’s perspective (...)
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  41. A Comparison of the Ethical Climate of Operating Rooms From the Perspective of Operating Room Nursing Students and Staff: An Analytical Study.Fatemeh Esmaelzadeh & Monirsadat Nematollahi - 2021 - Clinical Ethics 16 (3):259-267.
    Background The ethical climate is an essential component of organizational climate or culture. The ethical climate is necessary for clinical practice in operating rooms. Objective This study aimed to compare the ethical climate from the perspective of operating room nursing students and operating room staff of hospitals affiliated with Mashhad University of Medical Sciences, Iran. Method This analytical study was performed on 95 operating room nursing students and 169 operating room staff of hospitals in Mashhad, Iran. The students were selected (...)
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  42. The Ethics of Interpreter Use.Ben Gray & Jo Hilder - 2021 - Clinical Ethics 16 (4):354-358.
    Consulting with a patient where there is a language barrier is unethical unless the barrier is overcome. Every patient with a language barrier should have this prominently documented on their file. Much of the literature relating to working with interpreters suggests that a professional interpreter should be used all the time, although in practice this is far from standard practice. In this paper we look at the issue using normative ethics, utilitarian ethics, an argument based on equality of health outcomes (...)
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  43. The Effect of Providing Usual Care Only for Control Subjects on the Reliability of Results Obtained by Controlled Clinical Trials Assessing the Benefits of Diabetes Self-Management Educational Programs.Ehab Mudher Mikhael, Mohamed Azmi Hassali & Saad Hussain - 2021 - Clinical Ethics 16 (4):269-270.
    Diabetes self-management is a crucial part in the management of diabetic patients. Most randomized controlled clinical trials reported significant benefits by diabetes self-management education on DSM behaviors and metabolic control. Although the randomized clinical trials are the gold standard method in assessing the effectiveness of any intervention, including DSME interventions, the outcomes of these studies may reflect exaggerated effects; because in most of these studies, subjects in control group receive usual care with no any DSME. The lack of such education (...)
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  44. Children’s Medical Treatment Decision-Making: Reform or Review?Jo Bridgeman - 2021 - Clinical Ethics 16 (3):183-188.
    This article considers proposals to reform the law in response to recent high profile cases concerning the medical treatment of children, currently before Parliament in the Access to Palliative Care and Treatment of Children Bill 2019–21. It considers the proposed procedural change, to introduce a requirement for mediation before court proceedings, and argues that dispute resolution processes should be a matter of good practice rather than enshrined in law. It argues that the proposed substantive change to determination of best interests (...)
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  45. Supporting the Call for Improving the Code of Publication Ethics to Incorporate Editorial Decisions Regarding the Causation of Harm by Publication.Henk P. Giele - 2021 - Clinical Ethics 16 (3):163-164.
    It is argued that editors have a moral responsibility to reject submissions that they felt publication of which may cause harm. However, Ploeg and others suggest that there may exist better alternatives to rejection. He also called for the code of publication ethics to incorporate acknowledgement of the moral responsibility for the effects of publishing, define benefits and harms of publishing, and specify a range of actions an editor may take. This letter highlights a recent such rejection ostensibly made on (...)
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  46. Personal Prenatal Ultrasound Use by Women’s Health Professionals: An Ethical Analysis.Marielle S. Gross, Gail Geller & Anne Drapkin Lyerly - 2021 - Clinical Ethics 16 (4):364-370.
    Prenatal ultrasound use is skyrocketing despite limited evidence of improved outcomes. One factor driving this trend is the widely recognized psychological appeal of real-time fetal imaging. Meanwhile, considering imperfect safety evidence, U.S. professional guidelines dictate that prenatal ultrasound—a screening test—should be governed by expected clinical benefits—an opportunity for intervention. However, when women’s healthcare professionals themselves are pregnant, their access to ultrasound technology permits informal, personal use that may deviate from standard-of-care, e.g., for reassurance. Highlighting a poignant case wherein a pregnant (...)
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  47. Death Determination and Donation After Circulatory Death: Can Physicians Reconcile Cardiorespiratory Death and Irreversible Loss of Brain Function?Ahmeneh Ghavam - 2021 - Clinical Ethics 16 (4):307-314.
    Declaration of cardiorespiratory death, as defined by the Uniform Determination of Death Act, requires irreversible cessation of circulatory and respiratory function. A physician’s ability to confidently declare death is paramount because death is both a biological and social construct, and can afford a dying patient the opportunity to be an organ donor via donation after circulatory death. Inconsistencies related to cardiorespiratory death and DCD include the specific language used in the UDDA, specifically the use of the word “irreversible”. Additionally, in (...)
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  48. The Role of Compassion in Ethical Frameworks and Medical Practice.Acadia Fairchild - 2021 - Clinical Ethics 16 (4):302-306.
    Medicine has made great strides with advances in technology and outcomes. However, compassion is an element that often is missing from medical care and ethics. The paper discusses why compassion is the ideal physician and why it is important to medicine. The benefit of compassion in biomedical ethics by exploring three ethical frameworks is also explored. Compassion is an important concept that has a place in both medical care and ethical practice.
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  49. Moral Distress and Intention to Leave Intensive Care Units: A Correlational Study.Abbas Naboureh, Masoomeh Imanipour & Tahmine Salehi - 2021 - Clinical Ethics 16 (3):234-239.
    Moral distress is a fundamental problem in the nursing profession that affects nurses. Critical care nurses are more susceptible to this problem due to the nature of their work. Moral distress may, in turn, lead to several undesirable consequences. This study aimed to determine the relationship between moral distress and intention to leave the ward among critical care nurses. This descriptive-correlational study was conducted by census method on all eligible nurses who worked in Coronary Care Unit and Intensive Care Unit (...)
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  50. Lying to Patients: Ethics of Deception in Nursing.Drew A. Curtis, Jennifer M. Braziel, Robert A. Redfearn & Jaimee Hall - 2021 - Clinical Ethics 16 (4):341-346.
    While the ethical use of deception has been discussed in literature, the ethics and acceptability of nursing deception has yet to be studied. The current study examined nurses’ and nursing students’ ratings of the ethics and acceptability of nursing deception. We predicted that nurses and nursing students would rate a truthful vignette as more ethical than a deceptive vignette. We also predicted that participants would rate nursing deception as unethical and unacceptable. A mixed design was used to examine ethics scores (...)
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