39 found
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  1.  67
    When Should Conscientious Objection Be Accepted.Morten Magelssen - 2012 - Journal of Medical Ethics 38 (1):18-21.
    This paper makes two main claims: first, that the need to protect health professionals' moral integrity is what grounds the right to conscientious objection in health care; and second, that for a given claim of conscientious objection to be acceptable to society, a certain set of criteria should be fulfilled. The importance of moral integrity for individuals and society, including its special role in health care, is advocated. Criteria for evaluating the acceptability of claims to conscientious objection are outlined. The (...)
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  2.  8
    Importance of Systematic Deliberation and Stakeholder Presence: A National Study of Clinical Ethics Committees.Morten Magelssen, Reidar Pedersen, Ingrid Miljeteig, Håvard Ervik & Reidun Førde - 2020 - Journal of Medical Ethics 46 (2):66-70.
    BackgroundCase consultation performed by clinical ethics committees is a complex activity which should be evaluated. Several evaluation studies have reported stakeholder satisfaction in single institutions. The present study was conducted nationwide and compares clinicians’ evaluations on a range of aspects with the CEC’s own evaluation.MethodsProspective questionnaire study involving case consultations at 19 Norwegian CECs for 1 year, where consultations were evaluated by CECs and clinicians who had participated.ResultsEvaluations of 64 case consultations were received. Cases were complex with multiple ethical problems (...)
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  3.  72
    Four Reasons Why Assisted Dying Should Not Be Offered for Depression.Thomas Blikshavn, Tonje Lossius Husum & Morten Magelssen - 2017 - Journal of Bioethical Inquiry 14 (1):151-157.
    Recently, several authors have argued that assisted dying may be ethically appropriate when requested by a person who suffers from serious depression unresponsive to treatment. We here present four arguments to the contrary. First, the arguments made by proponents of assisted dying rely on notions of “treatment-resistant depression” that are problematic. Second, an individual patient suffering from depression may not be justified in believing that chances of recovery are minimal. Third, the therapeutic significance of hope must be acknowledged; when mental (...)
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  4.  30
    Four Roles of Ethical Theory in Clinical Ethics Consultation.Morten Magelssen, Reidar Pedersen & Reidun Førde - 2016 - American Journal of Bioethics 16 (9):26-33.
    When clinical ethics committee members discuss a complex ethical dilemma, what use do they have for normative ethical theories? Members without training in ethical theory may still contribute to a pointed and nuanced analysis. Nonetheless, the knowledge and use of ethical theories can play four important roles: aiding in the initial awareness and identification of the moral challenges, assisting in the analysis and argumentation, contributing to a sound process and dialogue, and inspiring an attitude of reflexivity. These four roles of (...)
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  5.  22
    Conscientious Objection to Intentional Killing: An Argument for Toleration.Bjørn K. Myskja & Morten Magelssen - 2018 - BMC Medical Ethics 19 (1):82.
    In the debate on conscientious objection in healthcare, proponents of conscience rights often point to the imperative to protect the health professional’s moral integrity. Their opponents hold that the moral integrity argument alone can at most justify accommodation of conscientious objectors as a “moral courtesy”, as the argument is insufficient to establish a general moral right to accommodation, let alone a legal right. This text draws on political philosophy in order to argue for a legal right to accommodation. The moral (...)
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  6.  14
    Ethics Support in Community Care Makes a Difference for Practice.Morten Magelssen, Elisabeth Gjerberg, Lillian Lillemoen, Reidun Førde & Reidar Pedersen - 2018 - Nursing Ethics 25 (2):165-173.
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  7.  39
    Rationing at the Bedside: Immoral or Unavoidable?Morten Magelssen, Per Nortvedt & Jan Helge Solbakk - 2016 - Clinical Ethics 11 (4):112-121.
    Although most theorists of healthcare rationing argue that rationing, including rationing that takes place in the physician–patient relationship is unavoidable, some health professionals strongly disagree. In a recent essay, Vegard Bruun Wyller argues that bedside rationing is immoral and thoroughly at odds with a sound view of the physician–patient relationship. We take Wyller to be an articulate exponent of the reluctance to participate in rationing found among some clinicians. Our essay attempts to refute the five crucial premises of his argument (...)
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  8.  63
    Conscientious Objection to Referrals for Abortion: Pragmatic Solution or Threat to Women’s Rights?Eva M. K. Nordberg, Helge Skirbekk & Morten Magelssen - 2014 - BMC Medical Ethics 15 (1):15.
    Conscientious objection has spurred impassioned debate in many Western countries. Some Norwegian general practitioners (GPs) refuse to refer for abortion. Little is know about how the GPs carry out their refusals in practice, how they perceive their refusal to fit with their role as professionals, and how refusals impact patients. Empirical data can inform subsequent normative analysis.
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  9.  10
    Secularity, Abortion, Assisted Dying and the Future of Conscientious Objection: Modelling the Relationship Between Attitudes.Morten Magelssen, Nhat Quang Le & Magne Supphellen - 2019 - BMC Medical Ethics 20 (1):1-7.
    Controversies arise over abortion, assisted dying and conscientious objection in healthcare. The purpose of the study was to examine the relationship between attitudes towards these bioethical dilemmas, and secularity and religiosity. Data were drawn from a 2017 web-based survey of a representative sample of 1615 Norwegian adults. Latent moderated structural equations modelling was used to develop a model of the relationship between attitudes. The resulting model indicates that support for abortion rights is associated with pro-secular attitudes and is a main (...)
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  10.  27
    Medical Students’ Attitudes Towards Conscientious Objection: A Survey.Sven Jakob Nordstrand, Magnus Andreas Nordstrand, Per Nortvedt & Morten Magelssen - 2014 - Journal of Medical Ethics 40 (9):609-612.
    Objective To examine medical students’ views on conscientious objection and controversial medical procedures.Methods Questionnaire study among Norwegian 5th and 6th year medical students.Results Five hundred and thirty-one of 893 students responded. Respondents object to a range of procedures not limited to abortion —notably euthanasia, ritual circumcision for boys, assisted reproduction for same-sex couples and ultrasound in the setting of prenatal diagnosis. A small minority would object to referrals for abortion. In the case of abortion, up to 55% would tolerate conscientious (...)
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  11.  37
    Sources of Bias in Clinical Ethics Case Deliberation.Morten Magelssen, Reidar Pedersen & Reidun Førde - 2014 - Journal of Medical Ethics 40 (10):678-682.
    A central task for clinical ethics consultants and committees (CEC) is providing analysis of, and advice on, prospective or retrospective clinical cases. However, several kinds of biases may threaten the integrity, relevance or quality of the CEC's deliberation. Bias should be identified and, if possible, reduced or counteracted. This paper provides a systematic classification of kinds of bias that may be present in a CEC's case deliberation. Six kinds of bias are discussed, with examples, as to their significance and risk (...)
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  12.  33
    Novel Paths to Relevance: How Clinical Ethics Committees Promote Ethical Reflection.Morten Magelssen, Reidar Pedersen & Reidun Førde - 2016 - HEC Forum 28 (3):205-216.
    How may clinical ethics committees inspire ethical reflection among healthcare professionals? How may they deal with organizational ethics issues? In recent years, Norwegian CECs have attempted different activites that stretch or go beyond the standard trio of education, consultation, and policy work. We studied the novel activities of Norwegian CECs by examining annual reports and interviewing CEC members. Through qualitative analysis we identified nine categories of novel CEC activities, which we describe by way of examples. In light of the findings, (...)
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  13.  12
    Roles and Responsibilities of Clinical Ethics Committees in Priority Setting.Morten Magelssen, Ingrid Miljeteig, Reidar Pedersen & Reidun Førde - 2017 - BMC Medical Ethics 18 (1):1-8.
    Background Fair prioritization of healthcare resources has been on the agenda for decades, but resource allocation dilemmas in clinical practice remain challenging. Can clinical ethics committees be of help? The aim of the study was to explore whether and how CECs handle priority setting dilemmas and contribute to raising awareness of fairness concerns. Method Descriptions of activities involving priority setting in annual reports from Norwegian CECs were studied and categorized through qualitative content analysis. Results Three hundred thirty-nine reports from 38 (...)
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  14.  27
    Acceptable Attitudes and the Limits of Tolerance: Understanding Public Attitudes to Conscientious Objection in Healthcare.Astrid Haaland Barlaup, Åse Elise Landsverk, Bjørn Kåre Myskja, Magne Supphellen & Morten Magelssen - 2019 - Clinical Ethics 14 (3):115-121.
    BackgroundThe public’s attitudes to conscientious objection are likely to influence political decisions about CO and trust towards healthcare systems and providers. Few studies examine the pub...
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  15.  6
    Roles and responsibilities of clinical ethics committees in priority setting.Morten Magelssen, Ingrid Miljeteig, Reidar Pedersen & Reidun Førde - 2017 - BMC Medical Ethics 18 (1):68.
    Fair prioritization of healthcare resources has been on the agenda for decades, but resource allocation dilemmas in clinical practice remain challenging. Can clinical ethics committees be of help? The aim of the study was to explore whether and how CECs handle priority setting dilemmas and contribute to raising awareness of fairness concerns. Descriptions of activities involving priority setting in annual reports from Norwegian CECs were studied and categorized through qualitative content analysis. Three hundred thirty-nine reports from 38 CECs were studied. (...)
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  16.  7
    Professional and Conscience-Based Refusals: The Case of the Psychiatrist's Harmful Prescription.Morten Magelssen - 2017 - Journal of Medical Ethics 43 (12):841-844.
    By way of a case story, two common presuppositions in the academic debate on conscientious objection in healthcare are challenged. First, the debate typically presupposes a sharp division between conscience-based refusals based on personal core moral beliefs and refusals based on professional reasons. Only the former might involve the moral gravity to warrant accommodation. The case story challenges this division, and it is argued that just as much might sometimes be at stake morally in refusals based on professional reasons. The (...)
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  17.  20
    Between Professional Values, Social Regulations and Patient Preferences: Medical Doctors' Perceptions of Ethical Dilemmas.Berit Bringedal, Karin Isaksson Rø, Morten Magelssen, Reidun Førde & Olaf Gjerløv Aasland - 2017 - Journal of Medical Ethics:medethics-2017-104408.
    Background We present and discuss the results of a Norwegian survey of medical doctors' views on potential ethical dilemmas in professional practice. Methods The study was conducted in 2015 as a postal questionnaire to a representative sample of 1612 doctors, among which 1261 responded. We provided a list of 41 potential ethical dilemmas and asked whether each was considered a dilemma, and whether the doctor would perform the task, if in a position to do so. Conceptually, dilemmas arise because of (...)
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  18.  16
    Attitudes Towards Assisted Dying Are Influenced by Question Wording and Order: A Survey Experiment.Morten Magelssen, Magne Supphellen, Per Nortvedt & Lars Johan Materstvedt - 2016 - BMC Medical Ethics 17 (1):24.
    BackgroundSurveys on attitudes towards assisted dying play an important role in informing public debate, policy and legislation. Unfortunately, surveys are often designed with insufficient attention to framing effects; that is, effects on the respondents’ stated attitudes caused by question wording and context. The purpose of this study was to demonstrate and measure such framing effects.MethodsSurvey experiment in which an eight-question survey on attitudes towards assisted dying was distributed to Norwegian citizens through a web-based panel. Two variations of question wording as (...)
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  19.  13
    The Norwegian National Project for Ethics Support in Community Health and Care Services.Morten Magelssen, Elisabeth Gjerberg, Reidar Pedersen, Reidun Førde & Lillian Lillemoen - 2016 - BMC Medical Ethics 17 (1):70.
    BackgroundInternationally, clinical ethics support has yet to be implemented systematically in community health and care services. A large-scale Norwegian project attempted to increase ethical competence in community services through facilitating the implementation of ethics support activities in 241 Norwegian municipalities. The article describes the ethics project and the ethics activities that ensued.MethodsThe article first gives an account of the Norwegian ethics project. Then the results of two online questionnaires are reported, characterizing the scope, activities and organization of the ethics activities (...)
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  20.  6
    Implementing Clinical Ethics Committees as a Complex Intervention: Presentation of a Feasibility Study in Community Care.Morten Magelssen, Heidi Karlsen, Reidar Pedersen & Lisbeth Thoresen - 2020 - BMC Medical Ethics 21 (1):1-9.
    Background How should clinical ethics support services such as clinical ethics committees be implemented and evaluated? We argue that both the CEC itself and the implementation of the CEC should be considered as ‘complex interventions’. Main text We present a research project involving the implementation of CECs in community care in four Norwegian municipalities. We show that when both the CEC and its implementation are considered as complex interventions, important consequences follow – both for implementation and the study thereof. Emphasizing (...)
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  21.  7
    Still a Moral Dilemma: How Ethiopian Professionals Providing Abortion Come to Terms with Conflicting Norms and Demands.Morten Magelssen, Jan Helge Solbakk, Viva Combs Thorsen & Demelash Bezabih Ewnetu - 2020 - BMC Medical Ethics 21 (1):1-7.
    BackgroundThe Ethiopian law on abortion was liberalized in 2005. However, as a strongly religious country, the new law has remained controversial from the outset. Many abortion providers have religious allegiances, which begs the question how to negotiate the conflicting demands of their jobs and their commitment to their patients on the one hand, and their religious convictions and moral values on the other.MethodA qualitative study based on in-depth interviews with 30 healthcare professionals involved in abortion services in either private/non-governmental clinics (...)
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  22.  3
    Ethical Challenges in Home-Based Care: A Systematic Literature Review.Anne Kari Tolo Heggestad, Morten Magelssen, Reidar Pedersen & Elisabeth Gjerberg - forthcoming - Nursing Ethics:096973302096885.
    Because of the transfer of responsibility from hospitals to community-based settings, providers in home-based care have more responsibilities and a wider range of tasks and responsibilities than before, often with limited resources. The increased responsibilities and the complexity of tasks and patient groups may lead to several ethical challenges. A systematic search in the databases MEDLINE, CINAHL, and SveMed+ was carried out in February 2019 and August 2020. The research question was translated into a modified PICO worksheet. A total of (...)
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  23.  8
    Can Clinical Ethics Committees Be Legitimate Actors in Bedside Rationing?Morten Magelssen & Kristine Bærøe - 2019 - BMC Medical Ethics 20 (1):1-8.
    Background Rationing and allocation decisions at the clinical level – bedside rationing – entail complex dilemmas that clinicians and managers often find difficult to handle. There is a lack of mechanisms and aids for promoting fair decisions, especially in hard cases. Reports indicate that clinical ethics committees sometimes handle cases that involve bedside rationing dilemmas. Can CECs have a legitimate role to play in bedside rationing? Main text Aided by two frameworks for legitimate priority setting, we discuss how CECs can (...)
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  24.  14
    How to Succeed with Ethics Reflection Groups in Community Healthcare? Professionals’ Perceptions.Heidi Karlsen, Lillian Lillemoen, Morten Magelssen, Reidun Førde, Reidar Pedersen & Elisabeth Gjerberg - 2019 - Nursing Ethics 26 (4):1243-1255.
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  25.  7
    In Pursuit of Goodness in Bioethics: Analysis of an Exemplary Article.Bjørn Hofmann & Morten Magelssen - 2018 - BMC Medical Ethics 19 (1):60.
    What is good bioethics? Addressing this question is key for reinforcing and developing the field. In particular, a discussion of potential quality criteria can heighten awareness and contribute to the quality of bioethics publications. Accordingly, the objective of this article is threefold: first, we want to identify a set of criteria for quality in bioethics. Second, we want to illustrate the added value of a novel method: in-depth analysis of a single article with the aim of deriving quality criteria. The (...)
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  26.  8
    Prenatal Diagnosis and the Christian Health Professional.Morten Magelssen - 2016 - Christian Bioethics 22 (3):325-339.
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  27.  3
    Bør Leger Ha Reservasjonsrett Ved Assistert Befruktning?Morten Magelssen & Torbjørn Folstad - 2011 - Etikk I Praksis - Nordic Journal of Applied Ethics 2 (2):7-22.
    Omfanget av helsepersonells reservasjonsrett har nylig vært gjenstand for debatt i Norge. Vi spør om leger bør ha reservasjonsrett ved utførelse og henvisning til assistert befruktning, og drøfter argumenter for og imot ved hjelp av et rammeverk med sju kriterier for vurdering av reservasjon. Reservasjonsrettens grunnleggende dilemma er hvordan to viktige hensyn, henholdsvis pasientens rett til behandling og hensynet til helsepersonellets moralske integritet, best kan ivaretas. Det argumenteres for at leger bør ha rett til å reservere seg mot å utføre, (...)
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  28.  2
    Clinical Ethics Committees in Nursing Homes: What Good Can They Do? Analysis of a Single Case Consultation.Morten Magelssen & Heidi Karlsen - 2022 - Nursing Ethics 29 (1):94-103.
    Background: Ought nursing homes to establish clinical ethics committees? An answer to this question must begin with an understanding of how a clinical ethics committee might be beneficial in a nursing home context – to patients, next of kin, professionals, managers, and the institution. With the present article, we aim to contribute to such an understanding. Aim: We ask, in which ways can clinical ethics committees be helpful to stakeholders in a nursing home context? We describe in depth a clinical (...)
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  29.  18
    Blood Sampling From Dying Patients: An Ethical Dilemma.Morten Magelssen, Pamela Åsten, Ellen Godal, Eirik Os, Anders Smith, Hanne Rusten Solås & Marit Helene Hem - 2012 - Clinical Ethics 7 (3):107-110.
  30.  11
    Professionals’ Experience with Conscientious Objection to Abortion in Addis Ababa, Ethiopia: An Interview Study.Morten Magelssen & Demelash Bezabih Ewnetu - 2021 - Developing World Bioethics 21 (2):68-73.
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  31.  4
    Establishing Clinical Ethics Committees in Primary Care: A Study from Norwegian Municipal Care.Morten Magelssen, Heidi Karlsen & Lisbeth Thoresen - forthcoming - HEC Forum:1-14.
    Would primary care services benefit from the aid of a clinical ethics committee? The implementation of CECs in primary care in four Norwegian municipalities was supported and their activities followed for 2.5 years. In this study, the CECs’ structure and activities are described, with special emphasis on what characterizes the cases they have discussed. In total, the four CECs discussed 54 cases from primary care services, with the four most common topics being patient autonomy, competence and coercion; professionalism; cooperation and (...)
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  32.  13
    Refusals to perform ritual circumcision: a qualitative study of doctors’ professional and ethical reasoning.Liv Astrid Litleskare, Mette Tolås Strander, Reidun Førde & Morten Magelssen - 2020 - BMC Medical Ethics 21 (1):1-7.
    Ritual circumcision of infant boys is controversial in Norway, as in many other countries. The procedure became a part of Norwegian public health services in 2015. A new law opened for conscientious objection to the procedure. We have studied physicians’ refusals to perform ritual circumcision as an issue of professional ethics. Qualitative interview study with 10 urologists who refused to perform ritual circumcision from six Norwegian public hospitals. Interviews were recorded and transcribed, then analysed with systematic text condensation, a qualitative (...)
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  33.  9
    Refractory Suffering at the End of Life and the Assisted Dying Debate: An Interview Study with Palliative Care Nurses and Doctors.Kristine Espegren Gustad, Åsta Askjer, Per Nortvedt, Olav Magnus S. Fredheim & Morten Magelssen - forthcoming - Sage Publications: Clinical Ethics.
    Clinical Ethics, Ahead of Print. BackgroundHow often does refractory suffering, which is suffering due to symptoms that cannot be adequately controlled, occur at the end of life in modern palliative care? What are the causes of such refractory suffering? Should euthanasia be offered for refractory suffering at the end of life? We sought to shed light on these questions through interviews with palliative care specialists.MethodsSemi-structured interviews with six nurses and six doctors working in palliative care in five Norwegian hospitals. Transcripts (...)
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  34.  8
    Opting Out. Conscience and Cooperation in a Pluralistic Society.Morten Magelssen - 2019 - The New Bioethics 25 (3):283-286.
    Volume 25, Issue 3, September 2019, Page 283-286.
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  35.  9
    Attitudes to Prenatal Screening Among Norwegian Citizens: Liberality, Ambivalence and Sensitivity.Morten Magelssen, Berge Solberg, Magne Supphellen & Guttorm Haugen - 2018 - BMC Medical Ethics 19 (1):80.
    Norway’s liberal abortion law allows for abortion on social indications, yet access to screening for fetal abnormalities is restricted. Norwegian regulation of, and public discourse about prenatal screening and diagnosis has been exceptional. In this study, we wanted to investigate whether the exceptional regulation is mirrored in public attitudes. An electronic questionnaire with 11 propositions about prenatal screening and diagnosis was completed by 1617 Norwegian adults. A majority of respondents supports increased access to prenatal screening with ultrasound and/or full genome (...)
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  36.  6
    Kristen Bioetikk På Defensiven.Morten Magelssen - 2011 - Etikk I Praksis - Nordic Journal of Applied Ethics 2 (2):18-30.
    I takt med sekulariseringen av Norge har den kristne bioetikken mistet innflytelse. For klassisk kristen etikk har det vært mange nederlag de siste tiårene. Men det har skjedd noe mer enn at klassiske kristne posisjoner har mistet tilslutning. De kristnes argumenter har også mistet appell og gjennomslagskraft i det offentlige rom, i en grad som ikke alene kan forklares med at antallet kristne synker. Artikkelen identifiserer fem hovedgrunner til at kristne argumenter i bioetikken ikke får gjennomslag i offentligheten: politisk liberalisme, (...)
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  37.  3
    Priority Setting at the Clinical Level: The Case of Nusinersen and the Norwegian National Expert Group.Reidun Førde, Sean Wallace, Magnhild Rasmussen & Morten Magelssen - 2021 - BMC Medical Ethics 22 (1):1-8.
    BackgroundNusinersen is one of an increasing number of new, expensive orphan drugs to receive authorization. These drugs strain public healthcare budgets and challenge principles for resource allocation. Nusinersen was introduced in the Norwegian public healthcare system in 2018. A national expert group consisting of physicians was formed to oversee the introduction and continuation of treatment in light of specific start and stop criteria.MethodsWe have studied experiences within the expert group with a special emphasis on their application of the start and (...)
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  38.  5
    Fastlegers Reservasjonsadgang – Hyklersk Eller Velbegrunnet?Morten Magelssen & Gard Olav Langeland - 2014 - Etikk I Praksis - Nordic Journal of Applied Ethics 2 (2).
    I debatten om fastlegers adgang til reservasjon mot henvisning til abort hevdet noen at reservasjonslegenes ønske er selvmotsigende og utilstrekkelig begrunnet. Det ble hevdet at reservasjonslegenes foreslåtte balansegang – å nekte henvisning til abort, men i stedet legge til rette for at en kollega henviser – er etisk inkonsistent og innebærer et særegent etisk hykleri, som har blitt kalt «de rene henders etikk». Ved nærmere ettersyn viser det seg at denne viktige kritikken har brodd mot noen måter å praktisere reservasjon (...)
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  39.  1
    Navigating Abortion Law Dilemmas: Experiences and Attitudes Among Ethiopian Health Care Professionals.Morten Magelssen, Jan Helge Solbakk, Viva Combs Thorsen & Demelash Bezabih Ewnetu - 2021 - BMC Medical Ethics 22 (1):1-7.
    BackgroundEthiopia’s 2005 abortion law improved access to legal abortion. In this study we examine the experiences of abortion providers with the revised abortion law, including how they view and resolve perceived moral challenges.MethodsThirty healthcare professionals involved in abortion provisions in Addis Ababa were interviewed. Transcripts were analyzed using systematic text condensation, a qualitative analysis framework.ResultsMost participants considered the 2005 abortion law a clear improvement—yet it does not solve all problems and has led to new dilemmas. As a main finding, the (...)
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