Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “ETHICS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,261 records · Page 70Linked to original sources
PubMed2005

A path analytic model of ethical conflict in practice and autonomy in a sample of nurse practitioners.

The purpose of this study was to test a causal model of ethical conflict in practice and autonomy in a sample of 254 nurse practitioners working in the primary care areas of family health, pediatrics, adult health and obstetrics/gynecology in the state of Maryland. A test of the model was conducted using a path analytic approach with LISREL 8.30 hypothesizing individual, organizational and societal/market factors influencing ethical conflict in practice and autonomy. Maximum likelihood estimation was used to estimate the parameters most likely to have generated the data. Forty-five percent of the total variance in ethical conflict was explained by the variables of ethical environment and ethical concern. Ethical concern, idealistic philosophy, ethics education in continuing education, percentage of client population enrolled in managed care, and market penetration explained 15% of the total variance in autonomy. The findings of this study indicate that the causal model of ethical conflict in practice and autonomy is consistent with the data and contributed to a fuller understanding of clinical decision making associated with practicing in a managed care environment. The final model supported a conceptual framework that is inclusive of three domains: individual, organizational and societal/market variables.

Adult↗
PubMed2003

Ethical issues and GenomEUtwin.

The post-genomic era is witnessing a proliferation of large-scale and population based genetic and genomic research projects. Many countries have or are establishing research biobanks and, as with GenomEUtwin, there is great interest in building multinational projects that link genotypic and phenotypic information from different centers. Clearly, the conduct of these projects raises multiple ethical issues, and the knowledge generated will continually recast the ethical, legal and social implications (ELSI) of such research. Maximising the scientific profit from this work while minimizing the risks to the participants requires full integration of ethics components into the structure and functioning of these projects. GenomEUtwin is organized around five intellectual cores, including an Ethics Core which operates across the entire project. This paper describes the role of the Ethics Core and presents an overview of the guidelines on which the principles followed in GenomEUtwin are based. We outline the major ethical concerns of our project and highlight complexities arising from diverse national legislations. Finally, the role of empirically based ethics research is discussed for understanding the ethical, legal, social and economic implications of human genetics and genomics research.

Confidentiality↗
PubMedDate not supplied

[Analysis of ethical aspects on human experimentation included in the instructions for the authors in 139 Brazilian scientific journals].

UNLABELLED: The concern with ethical standards during research in human subjects has been improving in Brazil during the last decade. Analysis of the ethical recommendations in instructions to authors may contribute to understand Brazilian Scientific Journals policies. OBJECTIVE: To evaluate the recommendations related to the ethics of investigation in human subjects in instructions to authors of Brazilian Scientific Journals. MATERIAL AND METHODS: Instructions to authors of 139 Brazilian Scientific Journals in medicine, biomedicine, nursery, odontology and general sciences were analysed. RESULTS: In one hundred ten (79.1%) of the 139 journals no recommendations related to ethics were found; 17 (12.2%) required previous approval by the institutional committee; 3 (2.1%) the procedures should be in accordance with the Declaration of Helsinki; 1 (0.7%) recommends the application of the informed consent; 5 (3.5%) recommend the use of Uniform requirements for manuscripts submitted to biomedical journals and 3 (2.1%) follow no specified rules. Twenty nine journals ask for references in ethics standards: in 15 (51.7%) the information must be included in the text; in 2 (6.8%) the authors must send a letter informing how the ethics standards were followed; in 1 (3.4%) a copy of the approval by the institutional committee must be included; in 1 (3.4%) believed the authors followed the standards and in 10 (34.4%) no specific reference was made. CONCLUSION: These results indicated that the majority of Brazilian Scientific Journals have little concern related to ethical aspects of research in human subjects included in instructions to authors. Even journals that make references to the ethical aspects the recommendations are quite different.

Brazil↗
PubMed2004

Annual meeting keynote address: Animal agriculture and emerging social ethics for animals.

Businesses and professions must stay in accord with social ethics, or risk losing their autonomy. A major social ethical issue that has emerged in the past three decades is the treatment of animals in various areas of human use. This point can be illustrated with numerous examples across all areas of animal use. These examples reflect society's moral concern having outgrown the traditional ethic of animal cruelty that began in biblical times and is encoded in the laws of all civilized societies. There are five major reasons for this new social concern, most importantly, the replacement of husbandry-based agriculture with industrial agriculture. This loss of husbandry to industry has threatened the traditional fair contract between humans and animals, and resulted in significant amounts of animal suffering arising on four different fronts. Because such suffering is not occasioned by cruelty, a new ethic for animals was required to express social concerns. Since ethics proceed from preexisting ethics rather than ex nihilo, society has looked to its ethic for humans, appropriately modified, to find moral categories applicable to animals. This concept of legally encoded rights for animals has emerged as a plausible vehicle for reform. The meaning of this ethical movement for animal agriculture is examined. Animal agriculture should explore ways to replace the animal husbandry lost to industrialization.

Animal Husbandry↗
PubMedDate not supplied

Ethical decision-making in nursing: implications for continuing education.

Staff nurses make ethical decisions daily. It is important that nurses know how to manage those decisions appropriately so that clients' ethical rights are honored without compromising the nurse's own moral conscience. In this phenomenological study, 19 staff nurses described their experiences in making ethical decisions in their practices. The interviews were transcribed and analyzed using Giorgi's phenomenological steps. The description of the nurses' experiences identified two distinct components of the ethical decision-making process: deliberation and integration. The findings suggest that nurses need to: a) recognize the ethical nature of their work, b) discern which ethical decisions are theirs to make, and c) acknowledge their authority to make ethical decisions in their practices. These findings have important implications for the continuing education of nurses regarding ethical decision-making.

Decision Making↗
PubMedDate not supplied

Managed care's Achilles heel: ethical immaturity.

How can physician executives determine the prevailing values in the managed care arena? What are the consequences when values statements are ignored during decision-making? These questions can be answered using a process called ethical reasoning, which is different and more productive than making moral judgments, such as "is managed care good or bad?" Failing to include ethical reasoning in executive offices and boardrooms is a form of ethical immaturity. It fuels public suspicion that managed care's goal may be maximizing profit at all costs, as opposed to seeking reasonable profit through provision of dependable and accessible health care services. One outcome of ethical reasoning is rediscovering the basic truth that running one's business on competitive rather than altruistic principles is ethical whenever greater efficiencies and economic growth enlarge the size of the pie for everyone. Reasonable self-interest is a perfectly acceptable reason to act ethically. The time has come for physician executives to develop a basic understanding of pragmatic ethics, and to appreciate the value of adding ethical reasoning to the decision-making process.

Altruism↗
PubMed2002

The ethical structure of Homeric society.

According to Plato, the society as reflected in Homer's epics is one without state power. In a society without state power, the act of revenge which the offended party prosecutes on the offender is the only disciplinary force, which should be endorsed by the ethical concepts of the society. Though the ethics of Homeric society has been analyzed before, there has been no theory on the ethical structure of Homeric society analyzed from the viewpoint of a society without state power. This study attempts to address this issue. Six concepts, "oath", "honor", "guest", "blood", "food" and "revenge" have been extracted from Homeric epics in comparison with the ethical structure of the Albanian Kanun. The ethical structure of Homeric society appears to belong to the category of the ethics of a society without state power, as represented by the ethical structure of the Kanun. Plato explicitly criticizes the ethical value system of Homeric society, which he thinks is alienated from the idea of Good.

Albania↗
PubMed2003

[Are academic radiologists evaluating the professional ethics of their residents?].

PURPOSE: Ethics is a challenging topic to teach and calls for competencies complex to pin point. Nevertheless, evaluation of ethics is a milestone on the way to autonomous medical practice. Our objectives were 1; To describe the "hidden knowledge" of academic radiologists evaluating the ethics of their residents; 2; To look for common denominators by comparing the evaluative practice of academic radiologists from France and Quebec. METHOD: 8 academic radiologists were interviewed on a critical episode of ethics evaluation of residents. The 8 transcripts were coded then co-coded using a USA reference from the radiology literature. RESULTS: 8/8 radiologists referred to 8 common issues of ethics, 7/8 shared an extra one, related to the teaching setting and 3/8 added the specific issue of consent to radiological procedure. CONCLUSION: The same ethical issues are shared by radiologists working in USA, France and Quebec. There are great similarities in evaluating ethics of residents among academic radiologists from France and Quebec, the diffusion of which being potentially useful to medical ethics training.

Ethics, Medical↗
PubMed2004

From the dead to the unborn: is there an ethical duty to save life?

In this paper I examine the question whether physicians have a legal and ethical duty to sustain pregnancies of women who die during the first or second trimester by the delivery of their fetuses. One ground for such a duty, on which I am focusing, is the duty of "special relationship" between the mother and the fetus. In my paper, I claim that the special relations the pregnant woman and the fetus have do provide such a moral duty. This moral duty derives from the special and intimate relationship between the mother and the fetus, which has two considerations that support it: the uniqueness of the fetus, and the mother's understanding and acknowledgement of such uniqueness. However, I argue that when the mother is dead, the nature of the relationship changes, as she is no more aware of her fetus and her relationship with it. Thus, the ethical duty of the mother to save her fetus' life should be declined upon the end of the relationship between the mother and her fetus with the mother's death. I support my argument by analyzing the special relationship between the mother and the fetus from four related ethical theories: ethics of relationships, responsibilities to society, ethics of families, and the ethics of care. By discussing these ethical theories, I show how responsibility to society in general, and to social entities, like families, in particular, constitute a moral duty towards the fetus, which, as aforesaid, no longer exists upon the pregnant woman's death. In addition to being social entities I further show how the intrinsic values of families play an important role in forming such a moral duty. Nevertheless, I argue that such an instrumental duty that enables the establishment of families no more exists as the pregnant woman is no more socially and morally part of the family she belonged to while alive. I strengthen my argument by applying ethics of care, and by analyzing the practical conclusion I arrived at from a religious perspective.

Brain Death↗
PubMed2006

Why our ethics curricula don't work.

The impact our ethics curricula have on students seems marginal at best. Students take the ethics courses we offer and pass the tests we give, but no one's behavior changes as a result. We fundamentally see ourselves teaching about ethics, which is slightly different than teaching ethics--and expecting behavior to change as a result of what is taught. The premise of this article is that our ethics courses are inadequate in content and form to the extent that they do not cultivate an introspective orientation to professional life. In some cases, they amount to little more than a study of various state dental practice acts or the Code of Ethics of the American Dental Association. Three specific weaknesses are identified in a typical ethics curriculum: 1) failure to recognize that more education is not the answer to everything; 2) ethics is boring; and 3) course content is qualitatively inadequate because it does not foster an introspective basis for true behavioral change. A fourth element, an innovation, is directed to this third weakness and entails implementing a precurriculum very early in the dental educational experience to address the disconnect between knowledge and action.

Behavior↗
PubMedDate not supplied

[Ethics and clinical drug trials].

During the last decade, biomedical ethics has known a rapid development. Research in man, including clinical drug trials, must now take into account ethical and legal requirements. The concept of the inviolability of the human person constitutes the basic tenet of biomedical ethics. Four main principles ensue: the principles of autonomy, of nonmaleficience, of beneficience and of justice. Some rules derive from them, for instance veracity, confidentiality, fidelity and respect of intimacy with regard to the subject of an experiment. From a practical standpoint, the design of a clinical trial must be scientifically sound, otherwise it cannot be ethical. An informed consent must be obtained, in written form, from the subject in a clinical trial and he must be aware of his right to withdraw from it at any moment. Moreover, the clinical trial must be monitored throughout its duration with respect to ethics. An ethics of the methodology of clinical trials must therefore exist. Ethics in research should be a way of thinking and behaving, inherent to the research training. The researcher should be keenly conscious of the ethical requirements involved in his work, if he wishes to avoid eventual external interventions.

Clinical Trials as Topic↗
PubMedDate not supplied

[Human genetics and ethics].

Many new problems and dilemmas have occurred in the practice of medical geneticists with the development of human genetics and its subdisciplines--molecular genetics, ethic genetics and juridical genetics. Devoid of the possibility to get adequate education, genetic informer or better to say, counsellor, although a scientist and a professional who has already formed his ethic attitudes, often finds himself in a dilemma when he has to decide whether a procedure made possible by progress of science is ethical or not. Thus, due to different attitudes, same decision is ethical for some, while for the others it is not. Ethic committees are groups of moral and good people trying to find an objective approach to certain genetic and ethic problems. There are more and more ethically unanswered questions in modern human genetics, and particularly in medical genetics. Medical geneticist-ethicist still encounters numerous problems in his work. These are, for example, experiments with human gametes and embryos, possibilities of hybridization of human gametes with animal gametes, in vitro fertilization, detection of heterozygotes and homozygotes for monogene diseases. early detection of chromosomopathies, substitute mothers, homo and hetero insemination, transplantation of fetal and cadeveric organs, uncontrolled consumption of alcohol and drugs, environmental pollution, etc. It is almost impossible to create a single attitude which shall be shared by all those engaged in human health protection. Therefore, it is best to have a neutral eugenetic attitude which allows free ethical choice of each individual, in any case, for the well-being of man.

Ethics, Medical↗
PubMed1980

[Introduction to the "Guidelines of Medical Ethics" of the Swiss Academy of Medical Sciences].

The guidelines of medical ethic are recommendations of the Swiss Academy of Medical Sciences to the medical doctors to overcome the difficulties of medicine and modern technics and social problems. In an introduction the duties of the physician and his behaviour in the hippocratic mind are exposed, without asking for an oath. The recommendations give I. essential rules of international health organisations and II. Medical-ethic guidelines regarding different questions: 1. research examinations on men 2. euthanasia 3. transplantation 4. artificial insemination 5. sterilisation, especially the operative sterilisation of mentally handicapped persons, without acceptation of the so-called forced sterilisation 6. medical-ethical committees. The newly founded medical-ethical commission of the Swiss Academy of Medical Sciences and its organisation with physicians and laymen is explained. Its different functions are: a) answers to inquiries of international or national organisations and of individual persons b) formulation of principal ideas for medical-ethical questions, which will arise also in the future, not only on research, but also on diagnostic, therapeutic or prophylactic problems. These medical-ethical guidelines are formulated in few words to help the medical doctor for a quick consultation. They give a legal ethic. The Swiss Academy of Medical Sciences considers this as one of her tasks: to guard and to guard and to advance ethical devices in medicine.

Ethics, Medical↗
PubMed1994

[Medical research and ethics. A questionnaire study among project leaders in the health region 4].

A questionnaire survey concerning attitudes to medical research ethics and the ethics committee was conducted among the 159 principal investigators whose protocols had been assessed by the regional ethics committee for biomedical research in the years 1986-92. Of the 119 respondents, 80% agreed that results of medical research can be misused and more than 60% that the public should have insight into and access to research results. More than half said it might be necessary to withhold results and that individual investigators should be able to do so to prevent misuse. Some 80% stated that ethical considerations had influenced their research, 12% that they would have had ethical scruples today about some of their previous projects and 60% that they currently emphasized ethical considerations more than they did in their earlier career. One in ten said they might have achieved better results if they could have paid less attention to ethics, while 45% would never publish studies of dubious ethical quality.

Attitude of Health Personnel↗
PubMed1996

Preventing harm and promoting ethical discourse in the helping professions: conceptual, research, analytical, and action frameworks.

The first in a series of 4 articles, this article provides an overview of the concepts and methods developed by a team of researchers concerned with preventing harm and promoting ethical discourse in the helping professions. In this article we introduce conceptual, research, analytical, and action frameworks employed to promote the centrality of ethical discourse in mental health practice. We employ recursive processes whereby knowledge gained from case studies refines our emerging conceptual model of applied ethics. Our participatory conceptual framework differs markedly from the restrictive model typically used in applied ethics. Our research relies on lived experiences of ethics, while our analytical framework draws attention to the multiple levels and contexts in which ethical dilemmas take place. Finally, our action framework is designed to collaborate with research participants and practitioners in making use of our data and interpretations. We demonstrate how the various frameworks inform each other in an integrative fashion. The article sets the stage for 2 case studies presented in subsequent articles.

Administrative Personnel↗
PubMed1991

Ethics consultation: skills, roles, and training.

A clinical ethics consultant gathers information firsthand at the patient's bedside. The consultant's special clinical skills include the ability to identify and analyze ethical problems; use reasonable clinical judgment; communicate effectively; negotiate and facilitate negotiations; and teach others how to construct their own ethical frameworks for medical decision making. Appropriate roles for the consultant include those of professional colleague, negotiator, patient and physician advocate, case manager, and educator. The training necessary for an ethics consultant includes substantial patient care experience, instruction in health care law and moral reasoning, and preparation in medical humanism. We favor a clinical model for ethics consultation. When urgent care is needed, other consultants promptly see the patient; the clinical ethics consultant can be expected to do the same.

Certification↗
PubMed2003

Effect of ethics consultations on nonbeneficial life-sustaining treatments in the intensive care setting: a randomized controlled trial.

CONTEXT: Ethics consultations increasingly are being used to resolve conflicts about life-sustaining interventions, but few studies have reported their outcomes. OBJECTIVE: To investigate whether ethics consultations in the intensive care setting reduce the use of life-sustaining treatments delivered to patients who ultimately did not survive to hospital discharge, as well as the reactions to the consultations of physicians, nurses, and patients/surrogates. DESIGN: Prospective, multicenter, randomized controlled trial from November 2000 to December 2002. SETTING: Adult intensive care units (ICUs) of 7 US hospitals representing a spectrum of institutional characteristics. PATIENTS: Five hundred fifty-one patients in whom value-related treatment conflicts arose during the course of treatment. INTERVENTIONS: Patients were randomly assigned either to an intervention (ethics consultation offered) (n = 278) or to usual care (n = 273). MAIN OUTCOME MEASURES: The primary outcomes were ICU days and life-sustaining treatments in those patients who did not survive to hospital discharge. We examined the same measures in those who did survive to discharge and also compared the overall mortality rates of the intervention and usual care groups. We also interviewed physicians and nurses and patients/surrogates about their views of the ethics consultation. RESULTS: The intervention and usual-care groups showed no difference in mortality. However, ethics consultations were associated with reductions in hospital (-2.95 days, P =.01) and ICU (-1.44 days, P =.03) days and life-sustaining treatments (-1.7 days with ventilation, P =.03) in those patients who ultimately did not survive to discharge. The majority (87%) of physicians, nurses, and patients/surrogates agreed that ethics consultations in the ICU were helpful in addressing treatment conflicts. CONCLUSION: Ethics consultations were useful in resolving conflicts that may have inappropriately prolonged nonbeneficial or unwanted treatments in the ICU.

Adult↗
PubMed2006

Establishment of ethical oversight of human research in El Salvador: lessons learned.

Human research is necessary for establishing the best approaches to health care, and should be overseen by a functional research ethics committee. However, in most low-income countries these committees are inadequate in providing the guidelines needed to ensure that ethics remain a prominent feature of human research. We developed a model of interaction with key institutions in low-income countries that had an interest in improving the infrastructure of human participant research. As a result, a research ethics committee was established at three hospitals in El Salvador. The skills gained from developing these committees and the interest shown by the Salvadoran government in rigorous ethical oversight of research involving human participants has allowed the creation of a national ethics committee, which serves as an entity to establish norms and guidelines for further development of research ethics committees in El Salvador. This model of interaction can also be used by institutions in high-income countries to create and strengthen the capacity for ethics in human research in low-income countries.

El Salvador↗