ethique_consentment_aptitutde

Content and Readability of Informed Consent Documents Approved by Research Ethics Committees of Health Institutions in South-East Nigeria

Fri, 04 Jul 2025 08:24:09 +0000

Author Names: Chime O.,Ezeome E.

Database Source: Embase Daily Updates

Journal Title: Journal of empirical research on human research ethics : JERHRE

Article Title: Content and Readability of Informed Consent Documents Approved by Research Ethics Committees of Health Institutions in South-East Nigeria

Year: 2025

Issue:

Volume:

Abstract: Variability and inadequacies in the contents of informed consent documents (ICDs) affect the quality of the informed consent (IC) process. This study assessed the content and readability of the 241 ICDs approved for biomedical research in South-East Nigeria from 2019 to 2021. The presence of basic elements for IC in the revised Common Rule and National Code was assessed, and the Flesh readability scores measured. Only 2 (0.8%) of the ICDs had all basic elements required by the Common Rule. Most ICDs fall below recommended readability indices. To improve the quality of the IC process, HRECs are to ensure that, while upholding research validity and credibility, ICDs are easy-to-read yet contain the basic information needed for decision-making by participants.

Factors associated with ethical decision-making ability among senior nursing interns: A national survey.

Tue, 01 Jul 2025 04:00:00 +0000

Nurse Education Today; 07/01/2025
Senior nursing interns frequently encounter ethical challenges due to the complex healthcare environment. In order to effectively address these challenges, ethical decision-making ability is particularly important. Identifying their ethical decision-making ability level and influencing factors is crucial for designing targeted interventions. To determine the level of ethical decision-making ability and identify its influencing factors among senior nursing interns. A cross-sectional study. A total of 1096 senior nursing interns from 44 universities across seven regions in China participated in the study. Data were collected using a general information questionnaire, the Judgement About Nursing Decision scale, the Chinese Moral Sensitivity Questionnaire-Revised Version, and the Hospital Ethical Climate Survey. Descriptive statistics, t -tests, one-way analysis of variance, Pearson's correlation, and multivariate linear regression were conducted using SPSS 27.0 for data analysis. Of the 1096 questionnaires, 935 were valid (85.3% response rate). The participants' mean scores for ethical decision-making ability, moral sensitivity, and hospital ethical climate were 276.41 (SD = 18.51), 42.01 (SD = 7.61), and 102.17 (SD = 14.63), respectively, reflecting moderate levels. Pearson's correlation revealed a positive relationship between the number of ways to acquire ethical knowledge and ethical decision-making ability (r = 0.077, p < 0.05). Regression analysis indicated that significant variables collectively accounted for 15.8% of the overall explanatory power on ethical decision-making ability (R2 = 0.158, P < 0.05). Senior nursing interns exhibited moderate ethical decision-making ability. To enhance this ability, educators are encouraged to develop targeted interventions, such as increasing opportunities for senior nursing interns to acquire ethical knowledge and enhancing their moral sensitivity via educational programs. Clinical institutions should foster a positive hospital ethical climate. These measures are crucial for improving the quality of care. • Senior nursing interns exhibited moderate level of ethical decision-making. • Hospital ethical climate was moderately positive. • Interns' moral sensitivity was found to be moderate. • Nursing ethics course scores correlated with ethical decision-making. • Moral sensitivity and ethical climate correlated with ethical decision-making.
(AN 184345964); ISSN: 02606917
CINAHL Complete

Philosophical and Ethical Underpinnings of the Medical Decision-Making Process: A Focus on Patient Values and Preferences.

Tue, 01 Jul 2025 04:00:00 +0000

Annals of Pharmacotherapy; 07/01/2025
(AN 185388584); ISSN: 10600280
CINAHL Complete

Psychiatric Patient Capacity Evaluations Likely Highlight Other Ethical Issues.

Tue, 01 Jul 2025 04:00:00 +0000

Medical Ethics Advisor; 07/01/2025
(AN 186051685); ISSN: 08860653
CINAHL Complete

Hermeneutics: An Ethical Journey (Reprinted With Permission).

Tue, 01 Jul 2025 04:00:00 +0000

Nursing Science Quarterly; 07/01/2025
Hermeneutics is an important philosophical mode of inquiry where discipline-specific theories and methodologies provide important windows of understanding of human experiences. The author in this article discusses the embedded truths of ethics found in the formal inquiry where human living quality phenomena are highlighted. The valuable insights and the importance to the future of the discipline of nursing focus on ideas for suggested further study.
(AN 186080904); ISSN: 08943184
CINAHL Complete

Navigating autonomy and decision-making capacity: Legal and ethical considerations in Medical Assistance in Dying for individuals with mental disorders in Portugal.

Tue, 01 Jul 2025 04:00:00 +0000

Death Studies; 07/01/2025
Portugal has recently amended its absolute prohibition on euthanasia and assisted suicide that now permits it conditionally and exonerates those providing this practice. People with a mental disorder or medical condition that affects their decision-making capacity (DMC), regardless of the mental disorder, its contemporaneity, or its connection to the decision itself are expressly excluded from this service unless they are assessed and deemed capacitous. In the absence of any statute concerning capacity or assisted decision-making, this legislation raises concerns about potential discrimination, conflicting with the presumption of capacity principle. A shift toward a DMC model is proposed. This model allows for the assessment of capacity for specific decisions, addressing the ethical implications of respecting or overriding a terminally ill person's autonomous will for medical assistance in dying. This review paper examines the challenges of assessing DMC in depression and examines several questions of ethical and legislative nature for future consideration.
(AN 186130022); ISSN: 07481187
CINAHL Complete

Exploring educators' epistemological worldviews and their influence on pedagogical decision-making in scientific ethics education at Malaysian universities.

Tue, 01 Jul 2025 04:00:00 +0000

Ethics & Behavior; 07/01/2025
Scientific Ethics Education (SEE) plays a pivotal role in cultivating students' understanding of complex ethical dilemmas and guiding their ethical decision-making processes. Effective instruction in this area requires a tailored approach suited for science students. This study explores how epistemological worldviews (EW) influence pedagogical strategies (PS) among educators in Malaysian universities. By investigating the diverse perspectives of 23 educators using the Fuzzy Delphi methodology, the research reveals a significant preference for contextualist and relativistic worldviews. These orientations support teaching methods that enhance critical thinking and ethical reasoning. Integrating these worldviews into the SEE curriculum fosters a transformative learning environment, equipping students with the ethical skills to navigate complex scientific challenges with integrity and proficiency.
(AN 186345563); ISSN: 10508422
CINAHL Complete

Large language models show amplified cognitive biases in moral decision-making

Fri, 20 Jun 2025 00:00:00 +0000

Proc Natl Acad Sci U S A. 2025 Jun 24;122(25):e2412015122. doi: 10.1073/pnas.2412015122. Epub 2025 Jun 20.

ABSTRACT

As large language models (LLMs) become more widely used, people increasingly rely on them to make or advise on moral decisions. Some researchers even propose using LLMs as participants in psychology experiments. It is, therefore, important to understand how well LLMs make moral decisions and how they compare to humans. We investigated these questions by asking a range of LLMs to emulate or advise on people's decisions in realistic moral dilemmas. In Study 1, we compared LLM responses to those of a representative U.S. sample (N = 285) for 22 dilemmas, including both collective action problems that pitted self-interest against the greater good, and moral dilemmas that pitted utilitarian cost-benefit reasoning against deontological rules. In collective action problems, LLMs were more altruistic than participants. In moral dilemmas, LLMs exhibited stronger omission bias than participants: They usually endorsed inaction over action. In Study 2 (N = 474, preregistered), we replicated this omission bias and documented an additional bias: Unlike humans, most LLMs were biased toward answering "no" in moral dilemmas, thus flipping their decision/advice depending on how the question is worded. In Study 3 (N = 491, preregistered), we replicated these biases in LLMs using everyday moral dilemmas adapted from forum posts on Reddit. In Study 4, we investigated the sources of these biases by comparing models with and without fine-tuning, showing that they likely arise from fine-tuning models for chatbot applications. Our findings suggest that uncritical reliance on LLMs' moral decisions and advice could amplify human biases and introduce potentially problematic biases.

PMID:40540596 | DOI:10.1073/pnas.2412015122

Hermeneutics: An Ethical Journey (Reprinted With Permission)

Fri, 20 Jun 2025 00:00:00 +0000

Nurs Sci Q. 2025 Jul;38(3):223-225. doi: 10.1177/08943184251335605. Epub 2025 Jun 20.

ABSTRACT

Hermeneutics is an important philosophical mode of inquiry where discipline-specific theories and methodologies provide important windows of understanding of human experiences. The author in this article discusses the embedded truths of ethics found in the formal inquiry where human living quality phenomena are highlighted. The valuable insights and the importance to the future of the discipline of nursing focus on ideas for suggested further study.

PMID:40539588 | DOI:10.1177/08943184251335605

A Bioethical Perspective on Orthopaedic Robot-Assisted Surgery: Consent, Access, and Accountability.

Wed, 18 Jun 2025 04:00:00 +0000

Journal of Bone & Joint Surgery, American Volume; 06/18/2025
(AN 186014815); ISSN: 00219355
CINAHL Complete

Artificial Intelligence and Decision-Making in Oncology: A Review of Ethical, Legal, and Informed Consent Challenges

Tue, 17 Jun 2025 00:00:00 +0000

Curr Oncol Rep. 2025 Jun 17. doi: 10.1007/s11912-025-01698-8. Online ahead of print.

ABSTRACT

PURPOSE OF REVIEW: Artificial Intelligence (AI) integration in oncology is transforming therapeutic decision-making by providing clinical decision support. AI may improve treatment precision, but it raises ethical, legal, and informed consent issues. This review examines these paramount AI implementation issues in cancer care. This systematic review followed the PRISMA 2020 guidelines and was prospectively registered in the PROSPERO (CRD420251046482) database. A comprehensive literature search was conducted in PubMed, Embase, and the Cochrane CENTRAL Library to identify studies published between January 2015 and May 2025. AI-supported oncology therapeutic decision-making studies with ethical, legal, or informed consent implications were eligible.

RECENT FINDINGS: Fifteen studies met the inclusion criteria. AI applications were found to support treatment recommendations, personalize drug dosing, and improve adherence and patient management. Despite these benefits, the review highlighted key concerns, including algorithmic transparency, unclear accountability in AI-guided decisions, data privacy, and gaps in patient understanding of AI's role in their care. AI has the potential to enhance oncological care, but ethical and legal issues must be addressed for safe and equitable implementation. Emphasis should be placed on developing robust informed consent models, mitigating algorithmic bias, and establishing clear legal accountability. Future research must establish ethical frameworks and regulatory mechanisms to protect patient autonomy and responsibly integrate AI into oncology.

PMID:40526332 | DOI:10.1007/s11912-025-01698-8

Hospital ethical climate mediates moral sensitivity and ethical decision-making ability

Fri, 13 Jun 2025 00:00:00 +0000

Nurs Ethics. 2025 Jun 13:9697330251350387. doi: 10.1177/09697330251350387. Online ahead of print.

ABSTRACT

BackgroundEthical decision-making ability is critical for senior nursing interns in addressing complex clinical dilemmas. However, the mediating role of hospital ethical climate in the relationship between moral sensitivity and ethical decision-making remains unexamined. This gap limits evidence-based strategies for enhancing interns' ethical decision-making and the delivery of high-quality care.Research AimsTo examine the mediating role of hospital ethical climate in the relationship between moral sensitivity and ethical decision-making among senior nursing interns, and to determine the relationship among these three variables.Research DesignThe study is a cross-sectional correlational design.Participants and Research ContextBetween August 2023 and January 2024, 1096 senior nursing interns from 44 universities across seven Chinese regions participated. The general information questionnaire, Judgement About Nursing Decision scale, Chinese Moral Sensitivity Questionnaire-Revised Version, and Hospital Ethical Climate Survey were distributed online. SPSS 27.0 was used for descriptive statistics and Pearson correlation analysis, while PROCESS macro handled mediation analysis.Ethical ConsiderationsThis study was approved by the Ethical Review Board of Xiangya School of Nursing, Central South University (No. E2023125).FindingsA total of 935 valid questionnaires were collected, with a response rate of 85.3%. Participants demonstrated moderate levels in ethical decision-making ability (276.41 ± 18.51), moral sensitivity (42.01 ± 7.61), and perceived hospital ethical climate (102.17 ± 14.63). There were significant positive correlations between each pair of these three variables (r = 0.248-0.474, p < 0.05). Moral sensitivity was associated with hospital ethical climate and ethical decision-making; hospital ethical climate mediated the relationship between moral sensitivity and ethical decision-making (β = 0.252-0.580, p < 0.05).DiscussionsComparing our findings with international research, this study highlights the influence of hospital ethical climate and moral sensitivity on ethical decision-making, emphasizing the mediating role of ethical climate and its implications.ConclusionsHospital ethical climate played a mediating role between moral sensitivity and ethical decision-making among senior nursing interns. Interventions targeting both are recommended to enhance ethical decision-making ability. Future research should explore specific measures for this population.

PMID:40514015 | DOI:10.1177/09697330251350387

The Ethics of Informed Consent for Data Registries: Moving Beyond Moral Minimalism to the High Ground

Thu, 12 Jun 2025 00:00:00 +0000

Bioethics. 2025 Jun 11. doi: 10.1111/bioe.13438. Online ahead of print.

ABSTRACT

There is a rapid increase in disease registries all over the world, propelled by innovations in electronic health records and computer technologies. Unlike the developed world, where many registries are well established, many disease registries in the developing world are still in their incipient stage. Establishment of disease registries is blighted by many ethical concerns. These include but are not limited to data capture and data transfer happening without explicit patient consent; data sharing with third parties for various purposes including research, policy making and advocacy; and retrospective consent waiver. This is compounded by the lack of ethical guidelines and international best practices. This paper presents an ethical analysis of the ethics of informed consent for data registries.

PMID:40501000 | DOI:10.1111/bioe.13438

From Awareness to Action: teaching ethical decision-making to health-care leaders

Mon, 09 Jun 2025 00:00:00 +0000

Perspect Biol Med. 2025;68(2):297-313. doi: 10.1353/pbm.2025.a962025.

ABSTRACT

This article presents a novel pedagogical approach for teaching ethical decision-making to health-care leaders, offered through a collaboration between the Harvard Medical School Center for Bioethics and the Advanced Ethics in Leadership Program (AELP). The approach centers on the AELP Triple-A Framework, which guides participants through the process of identifying ethical issues, analyzing competing values, and developing strategic, context-sensitive action plans. Unlike traditional medical ethics education that often focuses on patient-physician relationships and clinical challenges, this model emphasizes leadership challenges within complex health-care organizations and trains clinicians and health leaders to respond ethically and effectively to systemic pressures. The framework is taught through immersive, implementation-focused workshops that combine pre-readings, case-based exercises, small-group collaboration, and iterative feedback. A featured case study on physician unionization illustrates how participants used the framework to move beyond technical solutions and engage deeply with questions of professional identity, institutional culture, and ethical leadership. Through this exercise, participants reconceived unionization not merely as a labor dispute but as a reflection of deeper organizational and moral tensions. The workshop model fosters the development of ethical leadership skills that are both principled and practical, enabling clinicians to navigate the evolving challenges of contemporary health care with moral clarity and strategic competence.

PMID:40485457 | DOI:10.1353/pbm.2025.a962025

Desflurane, Climate Change, and PFAS Pollution: Appropriate Metrics for Science Based Ethical Decision Making

Wed, 04 Jun 2025 00:00:00 +0000

Anesth Analg. 2025 Jun 3. doi: 10.1213/ANE.0000000000007593. Online ahead of print.

NO ABSTRACT

PMID:40465255 | DOI:10.1213/ANE.0000000000007593

The Structure of Clinical Ethical Decision-Making: A Hospital System Needs Assessment.

Sun, 01 Jun 2025 04:00:00 +0000

HEC Forum; 06/01/2025
(AN 184671251); ISSN: 09562737
CINAHL Complete

The Ethics of Decentralized Clinical Trials and Informed Consent: Taking Technologies' Soft Impacts into Account.

Sun, 01 Jun 2025 04:00:00 +0000

Health Care Analysis; 06/01/2025
Decentralized clinical trials (DCTs) have the potential to advance the conduct of clinical trials, but raise several ethical issues, including obtaining valid informed consent. The debate on the ethical issues resulting from digitalization is predominantly focused on direct risks relating to for example data protection, safety, and data quality. We submit however, that a broader view on ethical aspects of DCTs is needed to touch upon the new challenges that come with the DCT practice. Digitalization has impacts that go beyond its direct purposes, by shaping behaviors, experiences, social relations, and values. We examine four elements of the informed consent procedure that are affected by DCTs, while taking these soft impacts of technologies into account: (i) informing participants and testing understanding, (ii) freedoms in relation to responsibilities and burdens, (iii) trust in participant-researcher relations, and (iv) impacts on the concept of privacy. Our analysis reveals that a broad view is key for optimal conduct of DCTs. In addition, it provides insight into the ethical impacts of DCTs on informed consent. Technologies such as DCTs potentially have profound impacts which are not immediately addressed by the existing regulatory frameworks, but nonetheless important to recognize. These findings can guide future practices of DCTs to foster the important values of clinical research in this novel approach for conducting clinical trials.
(AN 184954515); ISSN: 10653058
CINAHL Complete

Ethics of social media consent forms.

Sun, 01 Jun 2025 04:00:00 +0000

Journal of the American Academy of Dermatology; 06/01/2025
(AN 185103856); ISSN: 01909622
CINAHL Complete

Informed consent and ethical issues pertaining to female sterilization—Scoping review.

Sun, 01 Jun 2025 04:00:00 +0000

International Journal of Gynecology & Obstetrics; 06/01/2025
(AN 185305698); ISSN: 00207292
CINAHL Complete

Dual-roles and beyond: values, ethics, and practices in forensic mental health decision-making.

Sun, 01 Jun 2025 04:00:00 +0000

Medicine, Health Care & Philosophy; 06/01/2025
(AN 185423027); ISSN: 13867423
CINAHL Complete

A Shared Decision‐Making Model for Ethical Knee Pain Care in Older Muslim Adults.

Sun, 01 Jun 2025 04:00:00 +0000

Nursing & Health Sciences; 06/01/2025
Knee pain poses a substantial concern for older Muslim individuals during religious activities, such as performing salat. When assisting such patients with knee pain management, healthcare professionals may face ethical challenges. This paper explored ethical challenges encountered by older Indonesian Muslims experiencing knee pain, particularly, when considering total knee replacement surgery. The four‐box method was used to analyze these challenges, and a "Healthcare providers' Shared Decision‐Making Model for Muslim Older Adult Knee Pain Management in Indonesia" framework was established to address these challenges and guide professionals in collaborating with older Muslim adults for knee pain management.
(AN 185939113); ISSN: 14410745
CINAHL Complete

Ethical Considerations for Informed Consent in Acute Myocardial Infarction Clinical Trials

Tue, 27 May 2025 00:00:00 +0000

Circ Cardiovasc Interv. 2025 May 27:e015016. doi: 10.1161/CIRCINTERVENTIONS.124.015016. Online ahead of print.

ABSTRACT

Obtaining informed consent for clinical trial participation in acute myocardial infarction presents unique ethical and logistical challenges because of the patient distress, sedation, and the urgency of treatment. Traditional consent procedures often conflict with the narrow enrollment windows, prompting the use of legally authorized representatives and short- and long-form consent models. Although these approaches enable faster trial enrollment, they may compromise patient autonomy, introduce selection bias, or create postenrollment ethical dilemmas. This review explores the complexities of informed consent in acute myocardial infarction research, evaluating the advantages and limitations of existing strategies, including legally authorized representative consent, 2-step consent processes, and alternatives such as deferred and verbal consent. It also examines international variations in regulatory oversight and presents emerging solutions, such as preemptive consent, opt-out models, electronic platforms, and registry-based trials, to streamline the enrollment without delaying care. Ultimately, consent regulations should be re-evaluated and potentially relaxed to better support timely research. A thoughtful reassessment of consent frameworks is essential to ethically and effectively advance acute myocardial infarction research in time-sensitive settings.

PMID:40421544 | DOI:10.1161/CIRCINTERVENTIONS.124.015016

Ethical Aspects of the Development, Authorization, and Implementation of Applications in Ophthalmology Based on Artificial Intelligence - Statement of the German Ophthalmological Society (DOG) and the Professional Association of German Ophthalmologists (B

Wed, 21 May 2025 00:00:00 +0000

Klin Monbl Augenheilkd. 2025 May;242(5):605-613. doi: 10.1055/a-2542-5742. Epub 2025 May 21.

NO ABSTRACT

PMID:40398425 | DOI:10.1055/a-2542-5742

Dual-Physician Decision-Making for Unrepresented Patients: Legal and Ethical Obligations for the Second Nontreating Physician

Wed, 21 May 2025 00:00:00 +0000

J Clin Ethics. 2025 Summer;36(2):152-157. doi: 10.1086/734767.

ABSTRACT

AbstractPatients without capacity or a surrogate decision maker are known as unrepresented. These patients are highly vulnerable and frequently encountered in healthcare settings, though there is little consensus regarding how medical decisions should be made on these patients' behalf. Several states now require a second nontreating physician (SNTP) to evaluate nonemergent medical decisions for unrepresented patients. This article examines the legal and ethical challenges faced by SNTPs in the dual-physician authorization process, including biases in SNTP selection, time constraints, power dynamics, and accountability concerns. We propose a checklist to guide SNTPs in the care of unrepresented patients while minimizing biases and conducting rigorous risk-benefit assessments. Institutional strategies to address the challenges faced by SNTPs include systematic SNTP selection processes, protected time for evaluations, peer review panels, training to mitigate implicit bias, and iterative review for quality improvement. By providing an ethical framework for dual-physician authorization and actionable processes for minimizing bias, we seek to promote fair and thoughtful decision-making on behalf of unrepresented patients.

PMID:40397980 | DOI:10.1086/734767

Ethics, orthodoxies and defensive practice: a cross-sectional survey of nurse's decision-making surrounding CPR in deceased inpatients without Do Not Resuscitate orders.

Tue, 20 May 2025 04:00:00 +0000

BMC Medical Ethics; 05/20/2025
(AN 185280074); ISSN: 14726939
CINAHL Complete

Informed consent and ethics committee involvement in case reports and case series: cross-sectional meta-research study.

Mon, 19 May 2025 04:00:00 +0000

BMC Medical Ethics; 05/19/2025
(AN 185282073); ISSN: 14726939
CINAHL Complete

Ethical Challenges in Abortion Decision-Making: Perspectives from Perimenopausal Women's Nursing Care

Sat, 17 May 2025 00:00:00 +0000

Invest Educ Enferm. 2025 Apr;43(1):e01. doi: 10.17533/udea.iee.v43n1e01.

NO ABSTRACT

PMID:40381997 | PMC:PMC12085268 | DOI:10.17533/udea.iee.v43n1e01

A Shared Decision-Making Model for Ethical Knee Pain Care in Older Muslim Adults

Wed, 14 May 2025 00:00:00 +0000

Nurs Health Sci. 2025 Jun;27(2):e70124. doi: 10.1111/nhs.70124.

ABSTRACT

Knee pain poses a substantial concern for older Muslim individuals during religious activities, such as performing salat. When assisting such patients with knee pain management, healthcare professionals may face ethical challenges. This paper explored ethical challenges encountered by older Indonesian Muslims experiencing knee pain, particularly, when considering total knee replacement surgery. The four-box method was used to analyze these challenges, and a "Healthcare providers' Shared Decision-Making Model for Muslim Older Adult Knee Pain Management in Indonesia" framework was established to address these challenges and guide professionals in collaborating with older Muslim adults for knee pain management.

PMID:40367982 | DOI:10.1111/nhs.70124

Contemporary human rights violations in female sterilization care: legal and ethical considerations when coerced patients do consent

Tue, 13 May 2025 00:00:00 +0000

Monash Bioeth Rev. 2025 May 13. doi: 10.1007/s40592-025-00240-7. Online ahead of print.

ABSTRACT

In this piece we examine three forms of coercive or otherwise involuntary care that can occur with patient consent. To do so, we examine: (1) uninformed consent, (2) contingency-based consent and (3) constrained-market consent, amongst female sterilization patients. While there is broad recognition that "coercion" in sterilization care can manifest beyond instances of overt force and clarity on what constitutes coercion within clinical care, this has not translated to accountability. The current practice of identifying coercion through discrete civil cases may facilitate a narrow understanding of its contemporary prevalence; one that does not align with definitions of coercion supported by international human rights entities. We use three acute, and widely recognized, examples-hysterectomies in ICE detention facilities, India's sterilization camp deaths and birth control quotas for Uyghur women-as an entry point to highlight less overt contemporary forms of coercive sterilization care, pairing each example with data that explores prevalence at a broader population level. These data suggest less visible forms of coercion may persist relatively unchallenged-raising the ethical case for a functional approach to the measurement of coercion. In turn, we argue the relevant question may not be "when is coercion ethically justified in public health," but rather, why is coercion already the status quo?

PMID:40358902 | DOI:10.1007/s40592-025-00240-7

When Shared Decision-Making Breaks Down: Solving Moral Dilemmas in Antipsychotic Deprescribing

Fri, 09 May 2025 00:00:00 +0000

Harv Rev Psychiatry. 2025 May-Jun 01;33(3):170-177. doi: 10.1097/HRP.0000000000000430.

ABSTRACT

Many individuals diagnosed with psychosis make multiple attempts to discontinue antipsychotic medications. In this clinical challenge, we examine three snapshots in which shared decision-making (SDM) breaks down due to ongoing disagreement between the service user and the health care provider. We offer three perspectives on how to think about such disagreement: philosophical, psychological, and psychiatric perspectives. Finally, we propose shared deliberation as a potential model for when SDM fails, emphasizing an iterative process of mutual value sharing that avoids binary yes/no responses.

PMID:40344418 | DOI:10.1097/HRP.0000000000000430

Moral decision-making 'on the fly'

Thu, 08 May 2025 00:00:00 +0000

Psychol Res. 2025 May 8;89(3):98. doi: 10.1007/s00426-025-02126-z.

ABSTRACT

Over a century of research has focused on the consistency and inconsistency of human moral decision preferences. We proposed and found that moral decision preferences are flexible and shift towards newly learned moral rules when their application leads to utilitarian choices. Hence, decision-makers' psychological concept of morality is continually under construction (on the fly); based on learning, informed by changes in moral rules and specific moral contexts. Accordingly, in two experiments we developed and employed a two-stage supervised learning task, where participants learned novel moral rules based on corrective feedback of their moral decisions. Our empirical findings revealed that participants learn new moral rules, transfer these rules to tasks where no feedback is provided. However, participants make decisions based on the principle of maximizing utility rather than a learned rule when the rule conflicts with this principle, demonstrating further the flexibility of moral decision-making. In light of our proposal and findings that decision-makers' psychological concept of morality is continually under construction, moral decision-making researchers should integrate learning into their respective models and predictions.

PMID:40338369 | PMC:PMC12062067 | DOI:10.1007/s00426-025-02126-z

Autonomous Neurosurgical Robots: Ethical Concerns in Informed Consent and Global Health Equity

Wed, 07 May 2025 00:00:00 +0000

Bioethics. 2025 May 7. doi: 10.1111/bioe.13429. Online ahead of print.

NO ABSTRACT

PMID:40331526 | DOI:10.1111/bioe.13429

Ethical Approaches if Researchers Use Telehealth to Obtain Informed Consent.

Thu, 01 May 2025 04:00:00 +0000

Medical Ethics Advisor; 05/01/2025
(AN 185140581); ISSN: 08860653
CINAHL Complete

The role of patient outcomes in shaping moral responsibility in AI-supported decision making.

Thu, 01 May 2025 04:00:00 +0000

Radiography; 05/01/2025
Integrating decision support mechanisms utilising artificial intelligence (AI) into medical radiation practice introduces unique challenges to accountability for patient care outcomes. AI systems, often seen as "black boxes," can obscure decision-making processes, raising concerns about practitioner responsibility, especially in adverse outcomes. This study examines how medical radiation practitioners perceive and attribute moral responsibility when interacting with AI-assisted decision-making tools. A cross-sectional online survey was conducted from September to December 2024, targeting international medical radiation practitioners. Participants were randomly assigned one of four profession-specific scenarios involving AI recommendations and patient outcomes. A 5-point Likert scale assessed the practitioner's perceptions of moral responsibility, and the responses were analysed using descriptive statistics, Kruskal–Wallis tests, and ordinal regression. Demographic and contextual factors were also evaluated. 649 radiographers, radiation therapists, nuclear medicine scientists, and sonographers provided complete responses. Most participants (49.8 %) had experience using AI in their current roles. Practitioners assigned higher moral responsibility to themselves in positive patient outcomes compared to negative ones (χ2(1) = 18.98, p < 0.001). Prior knowledge of AI ethics and professional discipline significantly influenced responsibility ratings. While practitioners generally accepted responsibility, 33 % also attributed shared responsibility to AI developers and institutions. Patient outcomes significantly influence perceptions of moral responsibility, with a shift toward shared accountability in adverse scenarios. Prior knowledge of AI ethics is crucial in shaping these perceptions, highlighting the need for targeted education. Understanding practitioner perceptions of accountability is critical for developing ethical frameworks, training programs, and shared responsibility models that ensure the safe integration of AI into clinical practice. Robust regulatory structures are necessary to address the unique challenges of AI-assisted decision-making.
(AN 185202080); ISSN: 10788174
CINAHL Complete

Practical Ethics in Suicide: Research, Policy and Clinical Decision-Making.

Thu, 01 May 2025 04:00:00 +0000

British Journal of Psychiatry; 05/01/2025
(AN 185446235); ISSN: 00071250
CINAHL Complete

Ethical Decision-Making in Education: A Comparative Study of Teachers and Artificial Intelligence in Ethical Dilemmas

Sat, 26 Apr 2025 00:00:00 +0000

Behav Sci (Basel). 2025 Apr 4;15(4):469. doi: 10.3390/bs15040469.

ABSTRACT

The use of artificial intelligence (AI) in education supports long-term educational goals. AI enables learners to engage with ethical issues through simulations and virtual environments, allowing them to experience responsible decision-making in practice. Additionally, it assists administrators and educators in making data-driven decisions, contributing to the more effective formulation of educational policies. This study examines how teachers and AI address ethical educational dilemmas, comparing their decisions based on gender, experience, and education level. A total of 141 public school teachers in Turkey participated in the study, and their responses were compared with AI-generated decisions using Yin's nested multiple-case design. The scenarios were analyzed within the framework of five ethical perspectives: virtue ethics, deontological ethics, utilitarianism, social justice ethics, and situation ethics. AI aligned with teachers in five out of eight ethical dilemmas but differed in three cases, adopting a more analytical and outcome-oriented approach. In contrast, teachers placed greater emphasis on empathy and adherence to ethical principles. These findings highlight the differences in ethical decision-making between AI and teachers, emphasizing the role of AI in fostering ethical responsibility and awareness in education.

PMID:40282090 | PMC:PMC12024169 | DOI:10.3390/bs15040469

Readability of health research informed consent forms: case of the National Health Research Ethics Committee in Tanzania.

Tue, 22 Apr 2025 04:00:00 +0000

BMC Medical Ethics; 04/22/2025
(AN 184670928); ISSN: 14726939
CINAHL Complete

Cardiac vagal modulation predicts decision-making in sacrificial and everyday moral dilemmas

Tue, 15 Apr 2025 00:00:00 +0000

Sci Rep. 2025 Apr 15;15(1):13029. doi: 10.1038/s41598-025-96475-9.

ABSTRACT

Cardiac vagal modulation indicates the self-regulatory activity of the autonomic nervous system and can thus be used to assess an individual's ability to integrate physiological, cognitive, and emotional responses in the decision-making process. In this paper, cardiac vagal modulation, quantified by heart rate variability (HRV), was used to predict decision-making in two types of moral dilemmas: First, sacrificial dilemmas which create a moral conflict between utilitarian (acting to maximise aggregate well-being by sacrifice) and deontological (rejecting the sacrifice) alternatives; second, everyday dilemmas which create a conflict between altruistic (acting non-selfish) and egoistic (acting self-centered) alternatives. HRV was analysed in 112 healthy participants before, during, and after decision-making, allowing to assess not only self-regulatory ability (resting HRV) but also self-regulatory capacities (HRV during and after decision-making). HRV predicted concrete decisions, but effects were only found in women. In sacrificial dilemmas, deontological women showed a stronger vagal withdrawal but also a faster cardiac vagal recovery compared to high utilitarian women. In everyday moral dilemmas, altruism was associated with reduced vagal outflow and increased sympathetic activity. Findings suggest differences in the acquisition of self-regulatory capacities between decision-makers in both types of moral dilemmas, which can be measured by HRV.

PMID:40234633 | PMC:PMC12000318 | DOI:10.1038/s41598-025-96475-9

In Defense of Thinking and Talking in Bioethics and Shared Decision-Making

Mon, 07 Apr 2025 00:00:00 +0000

Am J Bioeth. 2025 Apr;25(4):56-58. doi: 10.1080/15265161.2025.2470684. Epub 2025 Apr 7.

NO ABSTRACT

PMID:40192702 | DOI:10.1080/15265161.2025.2470684

Challenges to Demonstrated Consent in Biobanking: Technical, Ethical, and Regulatory Considerations

Mon, 07 Apr 2025 00:00:00 +0000

Am J Bioeth. 2025 Apr;25(4):124-127. doi: 10.1080/15265161.2025.2470655. Epub 2025 Apr 7.

NO ABSTRACT

PMID:40192688 | DOI:10.1080/15265161.2025.2470655

Consent Is Dead, Long Live Ethical Oversight: Integrating Ethically Sourced Data into Demonstrated Consent Models

Mon, 07 Apr 2025 00:00:00 +0000

Am J Bioeth. 2025 Apr;25(4):112-115. doi: 10.1080/15265161.2025.2470657. Epub 2025 Apr 7.

NO ABSTRACT

PMID:40192687 | DOI:10.1080/15265161.2025.2470657

Moral conviction interacts with metacognitive ability in modulating neural activity during sociopolitical decision-making.