MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'BMC Medical Ethics' source. Mon, 06 Feb 2012 20:05:33 +0100 http://www.medworm.com/index.php?rid=5569185&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F13%2F1 This study will determine whether the tested intervention guides proxies in making decisions that concur with those of older adults, motivates the latter to record their wishes in writing, and yields savings for the healthcare system.Trial Registration: ISRCTN89993391 (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=5569185 Thu, 05 Jan 2012 05:00:00 +0100 5569185 http://www.medworm.com/index.php?rid=5512722&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F12%2F24 Conclusions: The prevailing theme of ethical concern focused on suspicions that the methods might not be properly implemented, and that further safeguards might be needed. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=5512722 Fri, 16 Dec 2011 05:00:00 +0100 5512722 http://www.medworm.com/index.php?rid=5418070&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F12%2F23 Conclusions: Nurse managers, regardless of their areas of practice, frequently experienced ethical issues. For dealing with these, team-approach needs to be emphasized. Proper understanding of the code of ethics is needed to provide basis for reasoning. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=5418070 Wed, 16 Nov 2011 05:00:00 +0100 5418070 http://www.medworm.com/index.php?rid=5418071&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F12%2F22 Conclusion: Although in theory benefit sharing is widely accepted as one of the means for promoting the social value of international collaborative health research, there is less agreement amongst major guidelines on the specific responsibilities of researchers over what is ethical in promoting the social value of research. Lack of consensus might have practical implications for efforts aimed at enhancing the social value of global health research undertaken in resource poor settings. Further developments in global research ethics require more reflection, paying attention to the practical realities of implementing the ethical principles in real world context. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=5418071 Tue, 15 Nov 2011 05:00:00 +0100 5418071 http://www.medworm.com/index.php?rid=5311087&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F12%2F21 Conclusions: Ethical issues do occur within the first session, the consciousness about ethical issues differs in Danish physiotherapy private practice, and reflections and acts are to a lesser extent based on awareness of ethical theories, principles and ethical guidelines. Beneficence towards the patient is a fundamental aspect of the physiotherapists' understanding of the first session. However, if the physiotherapist lacks a deeper ethical awareness, the physiotherapist may reason and/or act ethically to a varying extent: only an ethically conscious physiotherapist will know when he or she reflects and acts ethically. Further exploration of ethical issues in private practice is recommendable, and as management policy is deeply embedded within the Danish public sector there are reasons t... BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=5311087 Wed, 12 Oct 2011 04:00:00 +0100 5311087 http://www.medworm.com/index.php?rid=5281837&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F12%2F20 Conclusion: This study demonstrates that while in theory several efforts can be made to address the moral issues of concern to research participants and their communities in resource poor settings, quick fixes such as benefit sharing are not going to be straightforward. We suggest a need to pay closer attention to the processes through which ethical principles are enacted in practice and distil lessons on how best to involve individuals and communities in promoting ethical conduct of global health research in resource poor settings. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=5281837 Mon, 03 Oct 2011 04:00:00 +0100 5281837 http://www.medworm.com/index.php?rid=5269293&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F12%2F19 Conclusions: The values identified in this study offer the opportunity to better understand common ethical tensions that arise in rural healthcare and key differences between rural and urban palliative care. In particular, these values shed light on problematic health system and health policy changes. When initiatives violate deeply held values and hard won rural capacity to address the needs of their dying members is undermined, there are long lasting negative consequences. The social fabric of rural life is frayed. These findings offer one way to re-conceptualize healthcare decision making through consideration of critical values in order to support ethically good palliative care in rural settings. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=5269293 Wed, 28 Sep 2011 04:00:00 +0100 5269293 http://www.medworm.com/index.php?rid=5257513&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F12%2F18 Conclusion: Due to the integration of research and care, their different ethical perspectives become intertwined in the daily practice of pediatric oncology. Increasing awareness of what this means for the communication between parents and physicians is essential. Future research should focus on efforts that overcome the problems that the synchronicity of research and care evokes. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=5257513 Tue, 27 Sep 2011 04:00:00 +0100 5257513 http://www.medworm.com/index.php?rid=5257515&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F12%2F16 Conclusions: We conclude that potential risks to participants and communities cannot be wholly eliminated by anonymization of individual data and suggest that explicit review of proposed secondary uses, by a Data Access Committee or similar internal oversight body with suitable stakeholder representation, should be a required component of the trustworthy governance of any repository of data or specimens. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=5257515 Mon, 26 Sep 2011 04:00:00 +0100 5257515 http://www.medworm.com/index.php?rid=5257514&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F12%2F17 Conclusion: Canadian medical tourism brokers currently lack a common standard of care and accreditation, and are widely lacking in providing adequate risk communication for potential medical tourists. This has implications for the informed consent and consequent safety of Canadian medical tourists. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=5257514 Mon, 26 Sep 2011 04:00:00 +0100 5257514 http://www.medworm.com/index.php?rid=5156001&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F12%2F15 Conclusions: In our experience, Saudi mothers' preferences about BBN concerning newborns are varied, suggesting that a "one-size-fits-all" approach is inappropriate. A reversible, written informed consent detailing their preferences about BBN that would be kept in their medical records and utilized for guidance, if needed, may be the best solution, given this level of diversity. These findings merit further study. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=5156001 Mon, 22 Aug 2011 23:00:00 +0100 5156001 http://www.medworm.com/index.php?rid=5048476&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F12%2F14 ${item.shortDescription} (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=5048476 Mon, 18 Jul 2011 23:00:00 +0100 5048476 http://www.medworm.com/index.php?rid=4967734&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F12%2F13 Conclusions: These data have critical implications for future policy and research. Debates need to evolve beyond simply a binary discussion of whether CIRBs should replace local IRBs, to examine how and to what degree different models might operate, and what the relative advantages and disadvantages of each are. While some critics see CIRBs as panaceas, certain problems appear likely to continue. Careful consideration needs to be given to whether the advantages of local IRBs outweigh the problems that result, and whether a system can be developed that provides these benefits, while avoiding the disadvantages of local IRBs. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=4967734 Wed, 22 Jun 2011 23:00:00 +0100 4967734 http://www.medworm.com/index.php?rid=4932531&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F12%2F12 DiscussionThe question of 'medically futile' interventions and pointless life-prolonging treatment has been discussed by several authors. Dutch physicians call such interventions 'medisch zinloos' (senseless), and the Netherlands, as one of the first states to legislate on end-of-life situations, actually regulates such issues through appropriate laws. In contrast, leaving an 'advance directive' is not a viable option for Albanian ailing individuals of advanced age. Verbal requests are provided during periods of mental competence, but unfortunately such instructions are rarely taken seriously, and none of them has ever been upheld in a legal or other official forum.SummaryEnd-of-life decisions, treatment refusal and do-not-resuscitate policies are hazardous options in Albania, from the leg... BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=4932531 Tue, 14 Jun 2011 23:00:00 +0100 4932531 http://www.medworm.com/index.php?rid=4932532&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F12%2F11 DiscussionThis paper addresses four test characteristics of personal genome testing: its being a non-targeted type of testing, its high analytical validity, low clinical validity and problematic clinical utility. These characteristics raise their own specific ELSI, for example: non-targeted genetic profiling poses serious problems for information provision and informed consent. Questions about the quantity and quality of the necessary information, as well as about moral responsibilities with regard to the provision of information are therefore becoming central themes within ELSI-discussions of personal genome testing. Further, the current low level of clinical validity of genetic profiles raises questions concerning societal risks and regulatory requirements, whereas simultaneously it caus... BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=4932532 Mon, 13 Jun 2011 23:00:00 +0100 4932532 http://www.medworm.com/index.php?rid=4932533&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F12%2F10 Conclusions: The possible acceptability of this procedure during outbreaks represents an important opportunity to better characterize cause of death in Bangladesh which could lead to improved public health interventions to prevent these deaths. Difficulties for research teams will include engaging all major stakeholders in decision-making and quickly building a trusting relationship with the family and community, which will be difficult given the short window of time prior to the ritual bathing of the body. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=4932533 Sun, 12 Jun 2011 23:00:00 +0100 4932533 http://www.medworm.com/index.php?rid=4812204&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F12%2F8 Conclusion: The meanings of being in ethically difficult situations that led to the burden of a troubled conscience in those working in hemodialysis care, indicate the importance of increasing the level of communication within and among various professional groups - to transform being burdened by a troubled conscience into using conscience as a guide - in situations where no way of solving the problem seems to be good. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=4812204 Tue, 10 May 2011 23:00:00 +0100 4812204 http://www.medworm.com/index.php?rid=4741828&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F12%2F7 Conclusion: These findings may be useful in improving physician-patient communication in the medical setting. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=4741828 Wed, 20 Apr 2011 23:00:00 +0100 4741828 http://www.medworm.com/index.php?rid=4719348&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F12%2F6 Conclusions: The questions were addressed in different degrees of completeness. All arguments were assignable to the questions. The central ethical dimensions of ASCT could be discussed by reviewing the published literature. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=4719348 Thu, 14 Apr 2011 23:00:00 +0100 4719348 http://www.medworm.com/index.php?rid=4610252&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F12%2F5 DiscussionWe explore ethical issues in three key areas: protecting the interests of research participants, regulation of international collaborative genomics research and protecting the interests of scientists in low income countries. With regard to participants, important challenges are raised about community consultation and consent. Genomics research raises ethics and governance issues about sample export and ownership, about the use of archived samples and about the complexity of reviewing such large international projects. In the context of protecting the interests of researchers in low income countries, we discuss aspects of data sharing and capacity building that need to be considered for sustainable and mutually beneficial collaborations.SummaryMany ethical issues are raised when g... BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=4610252 Fri, 18 Mar 2011 00:00:00 +0100 4610252 http://www.medworm.com/index.php?rid=4482100&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F12%2F3 Conclusions: The findings have implications for planning the informed consent process in a largely rural setting with low levels of literacy. Greater effort needs to be directed towards developing simple participatory communication materials for the informed consent process. Furthermore, including both parents in a discussion about a child's participation in a research study may increase the extent to which consent is truly informed. Finally, continuing efforts need to be made to improve the communication skills of research workers with regard to explaining research processes and putting potential research participants at ease. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=4482100 Tue, 15 Feb 2011 00:00:00 +0100 4482100 http://www.medworm.com/index.php?rid=4349098&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F12%2F1 Conclusion: The causes of variability in approved consent forms and studies need to be better understood. However, mounting evidence of administrative and practical hurdles within current ethics governance systems combined with potential sub-optimal provision of information to and protection of research subjects support other calls for more scrutiny of research ethics practices and applicable revisions. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=4349098 Fri, 14 Jan 2011 00:00:00 +0100 4349098 http://www.medworm.com/index.php?rid=4298362&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F11%2F21 DiscussionThe assumption of anonymity of genetic data sets, however, is tenuous because genetic data are intrinsically self-identifying. Two types of re-identification are possible: the "Netflix" type and the "profiling" type. The "Netflix" type needs another small genetic data set, usually with less than 100 SNPs but including a personal identifier. This second data set might originate from another clinical examination, a study of leftover samples or forensic testing. When merged to the primary, unidentified set it will re-identify all samples of that individual.Even with no second data set at hand, a "profiling" strategy can be developed to extract as much information as possible from a sample collection. Starting with the identification of ethnic subgroups along with predictions of body... BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=4298362 Wed, 29 Dec 2010 00:00:00 +0100 4298362 http://www.medworm.com/index.php?rid=4277457&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F11%2F20 The authors have voluntarily retracted this article [1] and it is no longer available for online public display because portions of the article are similar to a previous publication [2]. While there was no intention to use pre-existing work without appropriate attribution, the authors nonetheless extend their apologies to Dr. Miller and all others concerned. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=4277457 Tue, 21 Dec 2010 00:00:00 +0100 4277457 http://www.medworm.com/index.php?rid=4096302&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F11%2F19 Conclusion: A response rate of almost 60% proves the great interest of intensive care professionals in making patient-oriented end-of-life decisions. However, as long as patients do not make use of their right of co-determination, the enactment of the new law can be considered only a first important step forward. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=4096302 Wed, 20 Oct 2010 23:00:00 +0100 4096302 http://www.medworm.com/index.php?rid=4076689&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F11%2F17 Conclusions: : We conclude that: 1) there is a considerable diversity in preferences and perceptions of norm and current practice among respondents regarding which ME to be disclosed and by whom, 2) Distributions of preference and perception of norm were similar but significantly different from the distribution of perception of current practice, 3) most respondents preferred to be informed of ME and by at-fault physician, and 4) one third of respondents preferred to be informed of near-miss ME, with a higher percentage among females, older, and healthy individuals. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=4076689 Sun, 17 Oct 2010 23:00:00 +0100 4076689 http://www.medworm.com/index.php?rid=4076688&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F11%2F18 Conclusions: We conclude that: 1) there is a considerable diversity among Saudi views regarding consenting for retrospective research which may be related to health status, 2) the distribution of perceptions of norm was similar to the distribution of perceptions of current practice but different from that of preferences, and 3) MR and TR are perceived differently in regard to consenting. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=4076688 Sun, 17 Oct 2010 23:00:00 +0100 4076688 http://www.medworm.com/index.php?rid=3972450&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F11%2F16 Conclusions It is recommended that an international agreement is developed on what conditions should be attached to any sharing of human tissue samples across borders. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=3972450 Wed, 15 Sep 2010 23:00:00 +0100 3972450 http://www.medworm.com/index.php?rid=3972451&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F11%2F15 DiscussionAdvances in biotechnology have allowed medical devices to be used as destination therapy that are designed for the permanent support of cardiac function and/or respiration after irreversible loss of these spontaneous vital functions. For permanent support of cardiac function, single ventricle or biventricular mechanical assist devices and total artificial hearts are implanted in the body. Mechanical ventilators extrinsic to the body are used for permanent support of respiration. Clinical studies have shown that destination therapy with ventricular assist devices improves patient survival compared to medical management, but at the cost of a substantial alteration in end-of-life trajectories. The moral and legal assessment of the appropriateness and permissibility of complying with... BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=3972451 Tue, 14 Sep 2010 23:00:00 +0100 3972451 http://www.medworm.com/index.php?rid=3757345&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F11%2F13 Conclusions: Community engagement enabled researchers to take account of staff and community opinions and issues during the study and adapt messages and methods to address emerging ethical challenges. Field workers conducting informed consent faced complex issues and their understanding, attitudes and communication skills were key influences on ethical practice. Community consultation was a challenging concept to put into practice, illustrating the complexity of assessing information needs and levels of deliberation that are appropriate to a given study. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=3757345 Wed, 14 Jul 2010 23:00:00 +0100 3757345 http://www.medworm.com/index.php?rid=3671007&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F11%2F11 Conclusion: New knowledge about malnutrition in elder care related to ethical responsibility was illuminated by persons holding top positions. Malnutrition was stressed as an important dimension of the elder care quality. Governing at a distance meant having trust in the staff, on the one hand, and discomfort and distrust when confronted with reports of malnutrition, on the other. Distrust was directed at caregivers, because despite the fact that education had been provided, problems reappeared. Discomfort was felt when confronted with examples of poor nutritional care and indicates that the participants experienced failure in their ethical responsibility because the quality of nutritional care was at risk. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=3671007 Tue, 15 Jun 2010 23:00:00 +0100 3671007 http://www.medworm.com/index.php?rid=3640396&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F11%2F9 Background: There is a permanent need to evaluate and develop the ethical quality of scientific research and to widen knowledge about the effects of ethical issues. Therefore we evaluated whether informed consent is related to implementation and success in a lifestyle intervention study with older research participants. There is little empirical research into this topic. Methods: The subjects (n=597) are a subgroup of a random population sample of 1410 men and women aged 57-78 years who are participating in a 4-year randomized controlled intervention trial on the effects of physical exercise and diet on atherosclerosis, endothelial function and cognition. Data were collected in two steps: A questionnaire about informed consent was given to all willing participants (n=1324) three months aft... BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=3640396 Mon, 07 Jun 2010 23:00:00 +0100 3640396 http://www.medworm.com/index.php?rid=3511029&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F11%2F7 Conclusions: The results show that with or without prior experience in research, participants in this study had a reasonable understanding of research. The findings show that a decision about taking part in research is dependent on knowledge, education and also on social networks.The results demonstrate that the majority were supportive of health research and believe that research is beneficial to the welfare of society. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=3511029 Mon, 26 Apr 2010 23:00:00 +0100 3511029 http://www.medworm.com/index.php?rid=3456440&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F11%2F5 Conclusions: The participants see the benefits of including the calculation of the global immunological risk within transplantation. Such data, being more precise and rigorous, could be of help in their clinical work. However, in spite of the use of such scientific data, a place must be retained for the clinical judgment that allows a physician to make decisions based on medical data, professional expertise and knowledge of the patient. To act in the best interests of the patient is key to whether the calculation of the global immunological risk is employed. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=3456440 Thu, 08 Apr 2010 23:00:00 +0100 3456440 http://www.medworm.com/index.php?rid=3398440&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F11%2F4 Conclusions: Analysis of how cohort studies in various jurisdictions handle key ELS issues provides informative data for comparison and contrast. Consideration of these and other examples and further scholarly exploration of ELS issues provides insight on how best to address these aspects in ways that respect the well-being of participants, especially children who become research subjects at the start of their lives. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=3398440 Tue, 23 Mar 2010 00:00:00 +0100 3398440 http://www.medworm.com/index.php?rid=3346095&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F11%2F3 Conclusion: The consultation revealed that while there have been few attempts to find convergence on ethical issues between HIV/AIDS, TB and malaria vaccine trial fields to date, there is much common ground and scope for convergence work between stakeholders in the three fields. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=3346095 Tue, 09 Mar 2010 00:00:00 +0100 3346095 http://www.medworm.com/index.php?rid=3301628&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F11%2F2 Conclusions: The majority of respondents appear to hold attitudes in standing with current guidelines on informed consent however there was still a significant minority who held more paternalistic views to the consent process bringing into question the need for further training in the area. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=3301628 Tue, 23 Feb 2010 00:00:00 +0100 3301628 http://www.medworm.com/index.php?rid=3262295&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F11%2F1 Conclusions: Intensivists' documentation of their communication with substitute decision makers frequently outlined the proposed plan of treatment, but often lacked evidence of discussion relevant to whether the treatment plan was expected to improve the patient's condition. Legislative standards for determination of best interest, such as the Health Care Consent Act in Ontario, Canada, may provide guidance for intensivists to optimally document the rationales for proposed treatment plans. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=3262295 Wed, 10 Feb 2010 00:00:00 +0100 3262295 http://www.medworm.com/index.php?rid=2984432&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F10%2F19 DiscussionThe Italian scenario reflects the current animated debate, illustrating the difficulty intrinsic in rigid guidelines on the subject, especially when gestational age is taken as a reference parameter for the medical decision.SummaryConcerning the decision to interrupt or not to initiate resuscitation procedures on low gestational age newborns or on newborns affected by severe and highly invalidating diseases, physicians do not need rigid rules based or inflexible gestational age and birth weight guidelines. Guidance in addressing the difficult and trying issues associated with infants born at the margins of viability with a realistic assessment of the infant's clinical condition must be based on the infant's best interests, with clinicians and parents entering into what has been d... BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=2984432 Thu, 12 Nov 2009 00:00:00 +0100 2984432 http://www.medworm.com/index.php?rid=2930535&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F10%2F18 Conclusion: Dutch physicians substantiate their adherence to the criteria in a variable way with an emphasis on physical symptoms. The information they provide is in most cases sufficient to enable adequate review. Review committees' control seems to focus on (unbearable) suffering and on procedural issues. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=2930535 Tue, 27 Oct 2009 00:00:00 +0100 2930535 http://www.medworm.com/index.php?rid=2875310&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F10%2F17 Conclusions: Participatory methodologies enabled effective partnerships between researchers, participant representatives and community stakeholders to be developed and facilitated local dialogue and consensus on what constitutes a locally-appropriate standard of care in the context of a vaginal microbicide trial in this setting.Trial registration: Current Controlled Trials ISRCTN64716212 (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=2875310 Thu, 08 Oct 2009 23:00:00 +0100 2875310 http://www.medworm.com/index.php?rid=2757157&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F10%2F15 Conclusions: Prevalence of incapacity to consent to treatment in patients admitted to an acute internal medicine ward is high. While the standardized Silberfeld questionnaire and the MMSE are not appropriate for the evaluation of the capacity to consent in this setting, an assessment by the multidisciplinary medical team concurs with the evaluation by a senior psychiatrist. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=2757157 Tue, 01 Sep 2009 23:00:00 +0100 2757157 http://www.medworm.com/index.php?rid=2737285&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F10%2F14 Conclusion: We present ethical arguments in favor of disclosure, discuss how cultural context shapes the ethical issues, and recommend refinement of guidance for couples research of communicable diseases to assist investigators encountering these ethical issues in the future. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=2737285 Wed, 26 Aug 2009 23:00:00 +0100 2737285 http://www.medworm.com/index.php?rid=2875311&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F10%2F12 This article examines and discusses the ethical, medical and legal considerations that arise from the operation of umbilical cord banks in Mexico.DiscussionA number of experts have stated that the use of umbilical cord goes beyond the mere utilization of human tissues for the purpose of treatment. This tissue is also used in research studies: genetic studies, studies to evaluate the effectiveness of new antibiotics, studies to identify new proteins, etc. Meanwhile, others claim that the law and other norms for the functioning of cord banks are not consistent and are poorly defined. Some of these critics point out that the confidentiality of donor information is handled differently in different places. The fact that private cord banks offer their services as "biological insurance" in order ... BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=2875311 Thu, 13 Aug 2009 23:00:00 +0100 2875311 http://www.medworm.com/index.php?rid=2699124&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F10%2F12 This article examines and discusses the ethical, medical and legal considerations that arise from the operation of umbilical cord banks in Mexico.DiscussionA number of experts have stated that the use of umbilical cord goes beyond the mere utilization of human tissues for the purpose of treatment. This tissue is also used in research studies: genetic studies, studies to evaluate the effectiveness of new antibiotics, studies to identify new proteins, etc. Meanwhile, others claim that the law and other norms for the functioning of cord banks are not consistent and are poorly defined. Some of these critics point out that the confidentiality of donor information is handled differently in different places. The fact that private cord banks offer their services as "biological insurance" in order ... BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=2699124 Thu, 13 Aug 2009 23:00:00 +0100 2699124 http://www.medworm.com/index.php?rid=2633858&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F10%2F10 Conclusions: The heterogeneity in consent choices suggests individuals should be offeredsome choice in use of their information for different types of health research, even if limited toselectively opting-out. Some of the implementation challenges could be designed into theinteroperable electronic health record. However, many questions remain, including how best tocapture the opinions of those who are more privacy sensitive. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=2633858 Thu, 23 Jul 2009 23:00:00 +0100 2633858 http://www.medworm.com/index.php?rid=2576087&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F10%2F9 Conclusions: Some positive portrayals of the non-medical use of MPH for performance enhancement in the print media and bioethics discourses could entice further uses. Medicine and society need to prepare for more prevalent non-medical uses of neuropharmaceuticals by fostering better informed public debates. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=2576087 Sun, 05 Jul 2009 23:00:00 +0100 2576087 http://www.medworm.com/index.php?rid=2555599&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F10%2F7 Conclusion: The presence of TM is not uncommon amongst Egyptian individuals. We recommend further qualitative studies investigating aspects of TM involving a larger sample size distinguished by different types of illnesses and socio-economic variables, as well as those who have and have not participated in clinical research. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=2555599 Mon, 29 Jun 2009 23:00:00 +0100 2555599 http://www.medworm.com/index.php?rid=2504994&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F10%2F6 Conclusions: Our findings suggest that largely local and relatively ad hoc decision making processes are being made in relation to resource allocations for predictive genetic tests and that a more coordinated and, potentially, national approach to allocation decisions in this context may be appropriate. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=2504994 Wed, 17 Jun 2009 23:00:00 +0100 2504994 http://www.medworm.com/index.php?rid=2504995&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F10%2F5 Background: To determine the knowledge, attitudes and practices regarding organ donation in a selected adult population. Methods: Convenience sampling was used to generate a sample of 440; 408 interviews were successfully completed and used for analysis. Data collection was carried out via a face to face interview based on a pre-tested questionnaire in selected market places of Karachi, Pakistan. Data was analyzed using SPSS v.15 and associations were tested using the Pearson's Chi square test. Multiple logistic regression was used to find independent predictors of knowledge status and motivation of organ donation. Results: Knowledge about organ donation was significantly associated with education (p= 0.000) and socioeconomic status (p= 0.038). 70 / 198 (35.3%) people expressed a high moti... BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=2504995 Tue, 16 Jun 2009 23:00:00 +0100 2504995 http://www.medworm.com/index.php?rid=2504996&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F10%2F4 Conclusions Level of understanding of aims and methods of a specific research project seems to vary in relation to modalities of approaching research; most of the twins are well aware of having been asked to donate blood for biobanking activities, and seem to be motivated by a "pragmatic" attitude to blood/DNA donation. Genetic influences on this attitude were suggested. The framing of interests and concerns of healthy participants to genetic-epidemiological studies should be further pursued, since research, particularly for "common diseases", is increasingly relying on population surveys and biobanking. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=2504996 Mon, 15 Jun 2009 23:00:00 +0100 2504996 http://www.medworm.com/index.php?rid=2238201&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F10%2F2 Conclusions: More senior doctors in England and Wales oppose any step towards the legalisation of assisted dying than support this. Doctors who care for the dying were more opposed. This has implications for the ease of implementation of recently proposed legislation. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=2238201 Thu, 05 Mar 2009 05:00:00 +0100 2238201 http://www.medworm.com/index.php?rid=2189941&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F10%2F1 DiscussionParents want to do their best for their children, and socially and legally their role is to care for and protect them yet the complexities of the medical and research context can challenge their fulfilment of this role. Parents are simultaneously responsible for their child and cherish this role yet they are dependent on others when their child becomes sick. They are keen to exercise responsibility for deciding to enter a child in a trial yet can be fearful of making the 'wrong' decision. They make judgements about the threat of the child's condition as well as the risks of the trial yet their interpretations often differ from those of medical and research experts. Individual parents will experience these and other complexities to a greater or lesser degree depending on their per... BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=2189941 Mon, 16 Feb 2009 05:00:00 +0100 2189941 http://www.medworm.com/index.php?rid=2058891&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F9%2F19 Conclusion: The majority of physicians were in agreement with abortion for thalassemia major and Down's syndrome because of the overall prognosis, but opposed to abortion for hemophilia. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=2058891 Tue, 23 Dec 2008 05:00:00 +0100 2058891 http://www.medworm.com/index.php?rid=1973511&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F9%2F18 Conclusions: Because no one approach to consent satisfied even a simple majority of dialogue participants and the importance placed on personal controls, a mechanism should be developed for documenting consent choice for different types of research, including ways for individuals to check who has accessed their medical record for purposes other than clinical care. This could be done, for example, through a web-based patient portal to their electronic health record. Researchers and policy makers should continue to engage the public to promote greater public understanding of the research process and to look for feasible alternatives to existing approaches to project-specific consent for observational research. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=1973511 Wed, 19 Nov 2008 05:00:00 +0100 1973511 http://www.medworm.com/index.php?rid=1958603&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F9%2F17 Conclusions: Participants were more attuned to issues surrounding biobanks as compared to registries and demonstrated a higher level of concern regarding biobanks. As registries and biobanks expand, there is a need for critical analysis of suitable roles for REBs and subsequent guidance on these topics. The authors conclude by recommending REB participation in the creation of registries and biobanks and the eventual drafting of comprehensive legislation. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=1958603 Fri, 14 Nov 2008 05:00:00 +0100 1958603 http://www.medworm.com/index.php?rid=1917237&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F9%2F16 Conclusion: The use of the term "evidence-based ethics" should be discouraged, unless there is enough consensus on how to differentiate between high- and low-quality information produced by empirical ethics. In the meantime, whenever empirical information plays a role, the process of ethical decision-making should make use of systematic reviews of empirical studies that involve a critical appraisal and comparative discussion of data. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=1917237 Mon, 20 Oct 2008 04:00:00 +0100 1917237 http://www.medworm.com/index.php?rid=1891199&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F9%2F16 Conclusions: The use of the term evidence-based ethics should be discouraged, unless there is enough consensus on how to differentiate between high- and low-quality information produced by empirical ethics. In the meantime, whenever empirical information plays a role, the process of ethical decision-making should make use of systematic reviews of empirical studies that involve a critical appraisal and comparative discussion of data. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=1891199 Mon, 20 Oct 2008 04:00:00 +0100 1891199 http://www.medworm.com/index.php?rid=1840058&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F9%2F15 Conclusion: Notwithstanding the constraints in a developing country, in a population with low levels of literacy and education, the quality of informed consent found in this study can be considered acceptable for public health research. Education level of respondents and experience of research staff taking the consent were predictive of good quality informed consent. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=1840058 Tue, 30 Sep 2008 04:00:00 +0100 1840058 http://www.medworm.com/index.php?rid=1823218&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F9%2F14 Conclusion: Observance of medical ethics is inadequate in hospitals of Lahore. Doctors should be imparted formal training in medical ethics and national legislation on medical ethics is needed. Patients should be made aware of their rights to medical ethics. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=1823218 Thu, 25 Sep 2008 04:00:00 +0100 1823218 http://www.medworm.com/index.php?rid=1663133&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F9%2F13 Background: Errors have been the concern of providers and consumers of health care services. However, consumers' perception of medical errors in developing countries is rarely explored. The aim of this study is to assess community members' perceptions about medical errors and to analyse the factors affecting this perception in one Middle East country, Oman. Methods: Face to face interviews were conducted with heads of 212 households in two villages in North Al-Batinah region of Oman selected because of close proximity to the Sultan Qaboos University (SQU), Muscat, Oman. Participants' perceived knowledge about medical errors was assessed. Responses were coded and categorised. Analyses were performed using Pearson's 2, Fisher's exact tests, and multivariate logistic regression model whereve... BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=1663133 Tue, 29 Jul 2008 04:00:00 +0100 1663133 http://www.medworm.com/index.php?rid=1576707&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F9%2F12 Conclusion: Significant but varied comprehension of the informed consent process exists among parents who participate in research activities in northern Ghana and it appears the existing practices are fairly effective in informing research participants in the study area. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=1576707 Thu, 19 Jun 2008 04:00:00 +0100 1576707 http://www.medworm.com/index.php?rid=1530072&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F9%2F12 Conclusion: Significant but varied comprehension of the informed consent process exists among parents who participate in research activities in northern Ghana and it appears the existing practices are fairly effective in informing research participants in the study area. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=1530072 Thu, 19 Jun 2008 04:00:00 +0100 1530072 http://www.medworm.com/index.php?rid=1524415&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F9%2F11 In this article, we use the principlist approach to identify, analyse and attempt to solve the ethical problem raised by a pregnant woman's request for cesarean delivery in absence of medical indications. We use two different types of premises: factual (facts about cesarean delivery and specifically attitudes of obstetricians as derived from the EUROBS European study) and value premises (principles of beneficence and non-maleficence, respect for autonomy and justice). Beneficence/non-maleficence entails physicians' responsibility to minimise harms and maximise benefits. Avoiding its inherent risks makes a prima facie case against cesarean section without medical indication. However, as vaginal delivery can have unintended consequences, there is a need to balance the somewhat dissimilar ri... BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=1524415 Tue, 17 Jun 2008 04:00:00 +0100 1524415 http://www.medworm.com/index.php?rid=1453330&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F9%2F10 Conclusions: The number of themes generated for the consent form (N=18) is as many as for the information leaflet (N=19) and had several overlaps. This suggests that the consent form should be itemized to reflect the contents covered in the information leaflet. The participants opinion on components of the information leaflets and consent forms proved to be similar with WHO checklist on informed consent. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=1453330 Tue, 20 May 2008 04:00:00 +0100 1453330 http://www.medworm.com/index.php?rid=1406316&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F9%2F9 Conclusions: There are too few data to evaluate whether the rules and regulations permitting RWC protects - or is acceptable to - the public. However, any attempts to engage the public should take place in the context of findings from further basic research to attend to the apparently paradoxical findings of some of the current surveys. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=1406316 Tue, 29 Apr 2008 04:00:00 +0100 1406316 http://www.medworm.com/index.php?rid=1398714&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F9%2F8 Discussion Any action or decision made on a presumption is accepted in law and science as one based on judgement of a provisional situation. It should therefore allow the possibility of reversing the action or decision. Presumed consent to organ donation will not permit such reversal. Placing prime importance on the functionality of body organs and their capacity to sustain life rather than on explicit consent of the individual will lead to further debate about rights of ownership and potentially to questions about financial incentives and to whom benefits should accrue. Factors that influence donor rates are not fully understood and attitudes of the public to presumed consent require further investigation. Presuming consent will also necessitate considering how such a measure would be app... BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=1398714 Fri, 25 Apr 2008 04:00:00 +0100 1398714 http://www.medworm.com/index.php?rid=1395838&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F9%2F7 Conclusions: The open interview enables the perspectives of patients and carers to be heard, unfettered from the structure of closed questions. It also enables those patients or carers to take part who would be unable to participate in other study designs. The context is at least as important as the format of the research interview taking into account the relational circumstances with carers and appropriate ways of obtaining informed consent. Consent at the end of the interview could be a solution to enhancing participants control over the interview. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=1395838 Thu, 24 Apr 2008 04:00:00 +0100 1395838 http://www.medworm.com/index.php?rid=1333814&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F9%2F6 Conclusions: Outcomes assessment of research ethics committees should address the following questions: First, does research ethics committee review improve participants' understanding of the risks and potential benefits of studies? Second, does the process affect prospective participants' decisions about whether to participate in research? Third, does it change participants' subjective experiences in studies or their attitudes about research? Fourth, does it reduce the riskiness of research? Fifth, does it result in more research responsive to the local community's self-identified needs? Sixth, is research ethics committees' guidance to researchers actually being followed? (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=1333814 Fri, 28 Mar 2008 04:00:00 +0100 1333814 http://www.medworm.com/index.php?rid=1249641&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F9%2F4 Conclusions: Our findings suggest that the hybrid state created through the disclosure of research results about individuals that are perceived to be clinically relevant may produce neither sufficiently adequate clinical care nor sufficiently ethical research practices. These findings raise questions about the extent to which research can, and should, be made to serve clinical purposes, and suggest the need for further deliberation regarding any ethical obligation to communicate individual research results. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=1249641 Fri, 22 Feb 2008 05:00:00 +0100 1249641 http://www.medworm.com/index.php?rid=1222057&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F9%2F3 Conclusions: Only one third of the publications scrutinized recorded ERC approval and procurement of informed consent. However, there is a positive trend in documenting these ethical requirements in local postgraduate research and in the local medical journal. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=1222057 Mon, 11 Feb 2008 05:00:00 +0100 1222057 http://www.medworm.com/index.php?rid=1183874&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F9%2F2 Conclusions: Our findings suggest that consensus building through an ethics facilitation approach may be a commonality to the practice of ethics consultation in the US and Japan, while differences emerged in terms of recommendations, surrogate assessment, and assessing treatments. Further research is needed to appreciate differences not only among different nations including, but not limited to, countries in Europe, Asia and the Americas, but also within each country. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=1183874 Tue, 29 Jan 2008 05:00:00 +0100 1183874 http://www.medworm.com/index.php?rid=1174573&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F9%2F1 Background: In Nigeria, as in other developing countries, access to training in research ethics is limited, due to weak social, economic, and health infrastructure. The project described in this article was designed to develop the capacity of academic staff of the College of Medicine, University of Ibadan, Nigeria to conduct ethically acceptable research involving human participants. Methods: Three in-depth interviews and one focus group discussion were conducted to assess the training needs of participants. A research ethics training workshop was then conducted with College of Medicine faculty. A 23-item questionnaire that assessed knowledge of research ethics, application of principles of ethics, operations of the Institutional Review Board (IRB) and ethics reasoning was developed to be ... BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=1174573 Thu, 24 Jan 2008 05:00:00 +0100 1174573 http://www.medworm.com/index.php?rid=981577&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F8%2F11 Conclusion: Greater attention to community engagement is required to understand the diverse issues associated with tissue exportation. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=981577 Fri, 26 Oct 2007 04:00:00 +0100 981577 http://www.medworm.com/index.php?rid=881407&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F8%2F10 DiscussionEthical concerns relating to safety in microbicide research are a major international concern. However, in the urgency to develop a medically efficacious microbicide, some of these concerns may not have been anticipated. In the risk-benefit assessment of research protocols, both medical and psycho-social risk must be considered. In this paper four main areas that have a potential for medical and/or psycho-social harm are examined. Male partner involvement is controversial in the setting of covert use of microbicides. However, given the long-term exposure of men to experimental products, this may be methodologically, ethically and legally important. Covert use of microbicides may impact negatively on relationship dynamics leading to psychosocial harm to varying extents. The unexpe... BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=881407 Wed, 19 Sep 2007 00:20:22 +0100 881407 http://www.medworm.com/index.php?rid=829402&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F8%2F9 Conclusion: Overall, individuals in our sample recognize the value of medical research and have a great deal of trust regarding medical research and their participation in research. There were, however, concerns with the level of research risks associated with several types of medical research. Many also demonstrated confusion with certain research methodologies. We recommend 1) enhanced educational efforts regarding general research concepts to enhance the validity of informed consent and 2) further survey studies in other areas of Egypt to determine the generalizability of our results. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=829402 Wed, 29 Aug 2007 04:00:00 +0100 829402 http://www.medworm.com/index.php?rid=703832&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F8%2F8 Conclusions: Overall findings indicated a greater recognized degree of responsibilities and an increase in workload for Japanese ethics committees. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=703832 Fri, 29 Jun 2007 04:00:00 +0100 703832 http://www.medworm.com/index.php?rid=680255&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F8%2F7 Background: Evidence concerning how Japanese physicians think and behave in specific clinical situations that involve withholding or withdrawal of medical interventions for end-of-life or frail elderly patients is yet insufficient. Methods: To analyze decisions and actions concerning the withholding/withdrawal of life-support care by Japanese physicians, we conducted cross-sectional web-based internet survey presenting three scenarios involving an elderly comatose patient following a severe stroke. Volunteer physicians were recruited for the survey through mailing lists and medical journals. The respondents answered questions concerning attitudes and behaviors regarding decision-making for the withholding/withdrawal of life-support care, namely, the initiation/withdrawal of tube feeding a... BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=680255 Tue, 19 Jun 2007 04:00:00 +0100 680255 http://www.medworm.com/index.php?rid=634890&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F8%2F6 Conclusions: Time was of essence for the ethical encounter. Further, verbal and nonverbal positive behaviors by the physicians also contributed to higher ratings of ethical aspects. These results can help to improve quality of ethical practice in pediatric settings and are of relevance for teaching and policy makers. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=634890 Thu, 24 May 2007 04:00:00 +0100 634890 http://www.medworm.com/index.php?rid=606731&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F8%2F4 Discussion: Despite apparently intact cognition and comprehension of risks, a borderline subject may deliberately choose self-harm in order to fulfill abnormal psychological needs, or due to suicidality. Alternatively, such a subject may refuse enrollment due to transference or the desire to harm him or herself. Such phenomena could be precipitated or prevented by the interpersonal dynamics of the informed consent encounter. Summary: Caution should be exercised in obtaining informed consent for research from subjects with Borderline Personality Disorder. A literature review and recommendations for future research are discussed.Keywordsbioethics, informed consent, psychiatric research, borderline personality disorder, personality disorders, self-harm (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=606731 Thu, 10 May 2007 04:00:00 +0100 606731 http://www.medworm.com/index.php?rid=510539&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F8%2F2 DiscussionWe review this recent development of increasingly severe anti-doping control measures and find them based on questionable ethical grounds. The ethical foundation of the war on doping consists of largely unsubstantiated assumptions about fairness in sports and the concept of a level playing field. Moreover, it relies on dubious claims about the protection of an athletes health and the value of the essentialist view that sports achievements reflect natural capacities. In addition, costly anti-doping efforts in elite competitive sports concern only a small fraction of the population. From a public health perspective this is problematic since the high prevalence of uncontrolled, medically unsupervised doping practiced in amateur sports and doping-like behaviour in the general populat... BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=510539 Thu, 29 Mar 2007 04:00:00 +0100 510539 http://www.medworm.com/index.php?rid=384387&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F8%2F1 Conclusions: Most major health RECs in South Africa are well organized given the resource constraints that exist in relation to research ethics in developing countries. However, the gender, racial and occupational diversity of most of these RECs is suboptimal, and most RECs are not constituted in accordance with South African guidelines. Variability in the operations of and training needs of RECs is a reflection of apartheid-entrenched influences in tertiary education in SA. While legislation now exists to enforce standardization of research ethics review systems, no provision has been made for resources or capacity development, especially to support historically-disadvantaged institutions. Perpetuation of this legacy of apartheid represents a violation of the principles of justice and equ... BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=384387 Thu, 25 Jan 2007 07:00:00 +0100 384387 http://www.medworm.com/index.php?rid=330025&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F7%2F14 Background: Requirements for organ donation after cardiac or imminent death have been introduced to address the transplantable organs shortage in the United States. Organ procurement organizations (OPOs) increasingly use the Internet for organ donation consent. Methods: An analysis of OPO Web sites available to the public for enrollment and consent for organ donation. The Web sites and consent forms were examined for the minimal information recommended by the United States Department of Health and Human Services for informed consent. Content scores were calculated as percentages of data elements in four information categories: donor knowledge, donor consent reinforcement, donation promotion, and informed consent. Results: There were 60 Web sites for organ donation enrollment serving the 5... BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=330025 Fri, 22 Dec 2006 07:00:00 +0100 330025 http://www.medworm.com/index.php?rid=318257&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F7%2F13 Conclusions: The results presented in this work describe some relevant characteristics of the population seen at public health care institutions in Mexico. Poverty, limited or no education, and the complexity of the information provided to the patients enrolled in clinical trials, may question the validity of the informed consent procedure in this group of patients. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=318257 Wed, 13 Dec 2006 07:00:00 +0100 318257 http://www.medworm.com/index.php?rid=304674&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F7%2F12 DiscussionIn this paper, we present an ethical framework for pandemic influenza planning. The ethical framework was developed with expertise from clinical, organisational and public health ethics and validated through a stakeholder engagement process. The ethical framework includes both substantive and procedural elements for ethical pandemic influenza planning. The incorporation of ethics into pandemic planning can be helped if senior hospital administrators sponsor its use, by having stakeholders vet the framework, and by designing or identifying decision review processes. We discuss the merits and limits of an applied ethical framework for hospital decision-making, as well as the robustness of the framework.SummaryThe need for reflection on the ethical issues raised by the spectre of a ... BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=304674 Mon, 04 Dec 2006 07:00:00 +0100 304674 http://www.medworm.com/index.php?rid=239714&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F7%2F11 Conclusion: This study revealed that many Japanese people indicate an interest in undertaking advance planning. This study found that there is a range of preferences regarding how advance directives are undertaken, thus it is important to recognize that any processes put into place should allow flexibility in order to best respect patients wishes and autonomy. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=239714 Wed, 18 Oct 2006 06:00:00 +0100 239714 http://www.medworm.com/index.php?rid=187428&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F7%2F10 Conclusion: These exploratory studies support the position that there is no unified global field of bioethics. This is a problem if the only reason is parochialism. But these regional differences are probably of less concern if one notices that bioethics comes in many not always mutually understandable dialects. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=187428 Mon, 11 Sep 2006 06:00:00 +0100 187428 http://www.medworm.com/index.php?rid=449450&cid=s_31003_74_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F7%2F10 Conclusion: These exploratory studies support the position that there is no unified global field of bioethics. This is a problem if the only reason is parochialism. But these regional differences are probably of less concern if one notices that bioethics comes in many not always mutually understandable dialects. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=449450 Mon, 11 Sep 2006 04:00:00 +0100 449450 http://www.medworm.com/index.php?rid=161668&cid=s_31003_46_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F7%2F9 DiscussionOntario is in the process of implementing fourteen Local Health Integration Networks (LHINs). The implementation of the LHINs provides a rare opportunity to address systematically the unmet diverse care needs of people with disabilities and chronic illnesses. The core of this paper provides a series of composite case vignettes illustrating integration opportunities relevant to these populations, namely: (i) rehabilitation and services for people with disabilities; (ii) chronic illness and cancer care; (iii) senior's health; (iv) community support services; (v) children's health; (vi) health promotion; and (vii) mental health and addiction services. For each vignette, we interpret the governing principles developed by the LHINs--equitable access based on patient need, preserving p... BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=161668 Tue, 29 Aug 2006 06:00:00 +0100 161668 http://www.medworm.com/index.php?rid=34113&cid=s_31003_46_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F7%2F6 Conclusions: We found wide variation in approach and agree rates across sites that were accounted for, in part, by different approaches to accrual and idiosyncratic policies of the hospitals. This wide variation in approach and agree rates raises important challenges for research ethics boards and data protection authorities in determining when to waive consent requirements, when to press for increased quality control, when to permit local adaptation of the consent process, and when to permit alternatives to individual express consent. We offer several suggestions for those registries that require consent for participation. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=34113 Tue, 23 May 2006 06:00:00 +0100 34113 http://www.medworm.com/index.php?rid=12402&cid=s_31003_46_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F7%2F5 DiscussionIn the aftermath of SARS and with the spectre of a pandemic avian influenza, it is imperative that we (re)consider the obligations of HCPs for patients with severe infectious diseases, particularly diseases that pose risks to those providing care. It is of pressing importance that organizations representing HCPs give clear indication of what standard of care is expected of their members in the event of a pandemic. In this paper, we address the issue of special obligations of HCPs during an infectious disease outbreak. We argue that there is a pressing need to clarify the rights and responsibilities of HCPs in the current context of pandemic flu preparedness, and that these rights and responsibilities ought to be codified in professional codes of ethics. Finally, we present a brie... BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=12402 Thu, 20 Apr 2006 06:00:00 +0100 12402 http://www.medworm.com/index.php?rid=12403&cid=s_31003_46_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F7%2F4 Conclusions: Until a governmental governance body is established in Quebec to guarantee the protection of research participants and establish harmonized guidelines for the management of biobanks in medical research, it is definitely up to REBs to find solutions that the present lack of guidelines poses. The model presented in this article offers a practical solution on a day-to-day basis for REBs, as well as researchers by promoting an archivist to a pivotal role in the process. It assures protection of all participants who altruistically donate their samples to generate and improve knowledge for better diagnosis and medical treatment. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=12403 Thu, 06 Apr 2006 06:00:00 +0100 12403 http://www.medworm.com/index.php?rid=70014&cid=s_31003_46_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F7%2F3 Conclusion: The main conclusion is that in the absence of a legal regulatory framework for ART, there is likely to be an increase in the contradictions between the use of outdated legal precedents and the technical development of ART. Since much of the specialist discussion necessary for the formulation of a legal framework has already been carried out, the speedy enactment of comprehensive and at the same time flexible legislation would be highly desirable, but further wide-ranging discussion involving the general public is likely to be needed first. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=70014 Wed, 05 Apr 2006 06:00:00 +0100 70014 http://www.medworm.com/index.php?rid=12404&cid=s_31003_46_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F7%2F3 Conclusions: The main conclusion is that in the absence of a legal regulatory framework for ART, there is likely to be an increase in the contradictions between the use of outdated legal precedents and the technical development of ART. Since much of the specialist discussion necessary for the formulation of a legal framework has already been carried out, the speedy enactment of comprehensive and at the same time flexible legislation would be highly desirable, but further wide-ranging discussion involving the general public is likely to be needed first. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=12404 Wed, 05 Apr 2006 06:00:00 +0100 12404 http://www.medworm.com/index.php?rid=12405&cid=s_31003_46_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F7%2F2 DiscussionSocial Darwinism was foremost amongst the philosophies impacting views of human dignity in the decades leading up to Nazi power in Germany. Charles Darwin's evolutionary theory was quickly applied by others to human beings and social structure. The term 'survival of the fittest' was coined and seen to be applicable to humans. Belief in the inherent dignity of all humans was rejected by social Darwinists. Influential authors of the day proclaimed that an individual's worth and value were to be determined functionally and materialistically. The popularity of such views meant German doctors and nurses were ideologically prepared to accept Nazi social policies that promoted survival of only the fittest humans. These writings reveal five general presuppositions that strongly impacte... BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=12405 Tue, 14 Mar 2006 07:00:00 +0100 12405 http://www.medworm.com/index.php?rid=12406&cid=s_31003_46_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F7%2F1 Conclusion: While a lot of peer reviewed journals in the field of bioethics profile themselves as international journals, they certainly do not live up to what one would expect from an "international" journal. The fact that English speaking countries, and to a larger extent American authors, dominate the international journals in the field of bioethics is a clear geographic bias towards the bioethical discussions that are going on in these journals. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=12406 Fri, 13 Jan 2006 07:00:00 +0100 12406 http://www.medworm.com/index.php?rid=12407&cid=s_31003_46_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F6%2F11 DiscussionThe recent incipiency of "Evidence-Based Ethics" attests to this phenomenon and should be rejected as a solution to the current ambivalence toward the normative resolution of moral problems in a pluralistic society. While "evidence-based" is typically read in medicine and other life and social sciences as the empirically-adequate standard of reasonable practice and a means for increasing certainty, I propose that the evidence-based movement in fact gains consensus by displacing normative discourse with aggregate or statistically-derived empirical evidence as the "bottom line". Therefore, along with wavering on the fact/value distinction, evidence-based ethics threatens bioethics' normative mandate. The appeal of the evidence-based approach is that it offers a means of negotiating... BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=12407 Tue, 08 Nov 2005 07:00:00 +0100 12407 http://www.medworm.com/index.php?rid=12408&cid=s_31003_46_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F6%2F10 Conclusion: In the current era of globalized biomedical research, good ethics stewardship demands that every country, irrespective of its level of economic development, should have in place a functional research ethics review system in order to protect the dignity, integrity and safety of its citizens who participate in research. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=12408 Thu, 20 Oct 2005 06:00:00 +0100 12408 http://www.medworm.com/index.php?rid=12409&cid=s_31003_46_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F6%2F9 Conclusion: The estimated workload justifies specific and independent administrative and financial support for Research Ethics Committees. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=12409 Mon, 17 Oct 2005 06:00:00 +0100 12409 http://www.medworm.com/index.php?rid=12410&cid=s_31003_46_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F6%2F8 Conclusion: We applied a new method in which the results of principal component analysis and frequencies of answers to other questions were combined. From this we deduced that the precedent education used in Western countries was useful to help doctors acquire ethical sensitivity and was not against their will. A relationship was found between reading precedents and the influence of lawsuits, and it was thought that student participation-type precedent education would be useful for doctors in order to acquire ethical sensitivity. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=12410 Sat, 06 Aug 2005 06:00:00 +0100 12410 http://www.medworm.com/index.php?rid=12411&cid=s_31003_46_f&fid=31003&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6939%2F6%2F7 Conclusion: The surgeons seemed confident in their professional role although the many ethical dilemmas they experienced in trying to meet the expectations of patients, colleagues and society also made them professionally and personally vulnerable. (Source: BMC Medical Ethics) BMC Medical Ethics journals http://www.medworm.com/rss/comments.php?id=12411 Mon, 04 Jul 2005 06:00:00 +0100 12411