ethique_consentment_aptitutde

Moral craft: engaging with value pluralism in healthcare decision-making

Tue, 21 Oct 2025 08:25:01 +0000

Author Names: Parker M.

Database Source: Embase Daily Updates

Journal Title: Monash bioethics review

Article Title: Moral craft: engaging with value pluralism in healthcare decision-making

Year: 2025

Issue:

Volume:

Abstract: Healthcare professionals routinely navigate complex value conflicts that span personal, interpersonal, and organisational domains. This paper examines the concept of moral craftsmanship-the skilled practice of understanding, analysing, and working through value conflicts in healthcare settings-and argues that value pluralism provides a more realistic framework for healthcare ethics than approaches seeking overarching moral consensus. Through analysis of cases spanning clinical genetics, paediatric end-of-life care, and institutional resource allocation, the paper explores how value conflicts manifest across interconnected domains and explores the practical reasoning processes through which healthcare professionals successfully navigate seemingly intractable moral disagreements. Drawing on examples from clinical genetics counselling and recent analyses of dissensus in paediatric care, the paper argues that deep value pluralism is compatible with reasoned decision-making and that moral craftsmanship represents an essential skill for effective healthcare practice. Oversimplified ethical frameworks risk creating dangerous gaps between institutional processes and lived moral experience, potentially undermining public trust in healthcare systems. Healthcare institutions must develop approaches that acknowledge genuine value plurality while supporting practical decision-making, maintaining mechanisms for incorporating diverse public values, and addressing the moral residue that persists beyond immediate decisions.<br/>Copyright © 2025. The Author(s).

Click to consent? Ethical and legal reflections on the use of electronic informed consent for whole-body donation, with Turkiye as a case study

Tue, 21 Oct 2025 08:25:01 +0000

Author Names: Cavdar Lokumcu P.,Gurses IA.

Database Source: Embase Daily Updates

Journal Title: Anatomical sciences education

Article Title: Click to consent? Ethical and legal reflections on the use of electronic informed consent for whole-body donation, with Turkiye as a case study

Year: 2025

Issue:

Volume:

Abstract: The adoption of electronic informed consent (eIC) in health systems is expanding globally, yet its application in whole-body donation remains limited and underexplored. This article examines the ethical and legal dimensions of adopting eIC for body donation, with Turkiye serving as a case study. We discuss the potential benefits of eIC, including broader donor reach, improved comprehension of consent content, flexible and personalized decision-making, and increased transparency through stakeholder engagement. Conversely, key concerns such as the digital divide, security vulnerabilities, and lack of institutional and legislative readiness are also addressed. Special attention is given to the needs of elderly donors, the dominant demographic in body donation, and donors with disabilities, and the importance of inclusive practices that do not exacerbate existing inequalities. While eIC could strengthen ethical principles like autonomy and beneficence, it also raises questions regarding justice and non-maleficence. Without clear regulatory frameworks and institutional commitment, premature implementation may undermine trust. Although Turkiye presents unique regulatory and cultural challenges, these issues are broadly relevant to donation systems worldwide. Therefore, a cautious, hybrid model that combines digital accessibility with traditional consent pathways, supported by legal and ethical oversight, is recommended.<br/>Copyright © 2025 American Association for Anatomy.

Bridging ethical gaps in digital health research: a framework for informed consent aligned with NIH guidance.

Wed, 08 Oct 2025 04:00:00 +0000

BMC Medical Ethics; 10/08/2025
(AN 188515534); ISSN: 14726939
CINAHL Complete

Assessment of physicians' ethical dilemmas and decision-making in emergency departments in resource-limited settings: a study of selected public hospitals in Sidama regional state, Ethiopia, 2024.

Mon, 06 Oct 2025 04:00:00 +0000

BMC Emergency Medicine; 10/06/2025
(AN 188474060); ISSN: 1471227X
CINAHL Complete

The moral labour of food purchase decision-making – an ethnographic study among families in Denmark.

Wed, 01 Oct 2025 04:00:00 +0000

Appetite; 10/01/2025
(AN 187794956); ISSN: 01956663
CINAHL Complete

Ethical Considerations in Anesthesia Consent.

Wed, 01 Oct 2025 04:00:00 +0000

International Anesthesiology Clinics; 10/01/2025
(AN 187786893); ISSN: 00205907
CINAHL Complete

Ethical Approaches to Obtain Surrogate's Research Consent for Critically Ill Patient.

Wed, 01 Oct 2025 04:00:00 +0000

Medical Ethics Advisor; 10/01/2025
(AN 188146320); ISSN: 08860653
CINAHL Complete

Living on the Edge: Paradoxical Experiences With Ethics [Reprinted with Permission].

Wed, 01 Oct 2025 04:00:00 +0000

Nursing Science Quarterly; 10/01/2025
Paradox is living phenomenon that provides insights into straight thinking and diverse human experiences important to the discipline of nursing from a nursing philosophical theory–based approach. The author here delves into the metaphorical experience of living on the edge and the paradoxical concepts that assist the discipline in its thinking about artificial intelligence. Possible ethical implications of utilizing artificial intelligence from a humanbecoming ethos of understanding is utilized. The metaphorical implications for future disciplinary priorities are presented.
(AN 187842402); ISSN: 08943184
CINAHL Complete

It's My Life: An Ethical Analysis of Parent-Adolescent Decision-Making Conflict Over Cancer Treatment.

Mon, 01 Sep 2025 04:00:00 +0000

AACN Advanced Critical Care; 09/01/2025
(AN 187765783); ISSN: 15597768
CINAHL Complete

The moral distress, protective factors, and resilience: the role of ethical decision-making competence among student nurses.

Mon, 01 Sep 2025 04:00:00 +0000

Advances in Health Sciences Education; 09/01/2025
(AN 187625362); ISSN: 13824996
CINAHL Complete

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

Mon, 01 Sep 2025 04:00:00 +0000

Bioethics; 09/01/2025
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.
(AN 188364341); ISSN: 02699702
CINAHL Complete

Conscience and conscientiousness within surrogate decision making: Philosophical considerations on the ethical relevance of conscientiousness.

Mon, 01 Sep 2025 04:00:00 +0000

Clinical Ethics; 09/01/2025
Decisions at the end of life often result in conflicting opinions between medical and nursing professionals and the people concerned themselves. Especially when different beliefs and values clash, it can be difficult to understand each other's situation. Appropriate communication, with the necessary respect for the opinions and interests of other individuals, seems to be crucial here. However, if the person concerned is no longer able to express their own views on further treatment or possible withdrawal, support is often needed in the form of a surrogate decision maker, which poses specific challenges. This article deals with the ethically relevant difference between conscience and conscientiousness in the context of surrogate decision making. In the first step, due to the multitude of different views, it is shown what can be understood by conscience. By differentiating between building conscience, formation of conscience, and conscience conformity, a distinction is made between conscience and conscientiousness. In the second step, representatives are placed in relation to the concept established so far, and ethical implications are pointed out. The final step attempts not only to bring together the previous considerations and present suggestions for action but also to clarify common misunderstandings regarding the two terms. The ethical relevance of conscientiousness and the willingness of representatives to be open to other views on the one hand and to remain true to their own values on the other appear to be essential.
(AN 187648184); ISSN: 14777509
CINAHL Complete

Between virtues and principles Czech social workers' approaches to moral decision-making.

Mon, 01 Sep 2025 04:00:00 +0000

European Journal of Social Work; 09/01/2025
To analyse and understand how social workers approach ethical issues in everyday practice and make moral decisions and the role the code of ethics plays in this process, a mix of quantitative and qualitative research strategies was used. The analysis of the statements of 111 social workers showed that their moral decision-making was anchored in principle- or virtue-based approaches, so the code of ethics was not always a key reference point of their thinking. The thematic analysis resulted in two semantic themes: moral decision-making as an individual matter and as an interaction between the employee and the organisational environment, as well as the latent theme of professionalism. The potential conflicts between codes of ethics, organisational norms and personal identities pose a significant danger to professionalism, as does individual and organisational formal approaching moral issues. Theoretical and practical implications of these findings are presented.
(AN 187408981); ISSN: 13691457
CINAHL Complete

The six‐thinking‐hat technique for decision‐making in biomedical ethics.

Mon, 01 Sep 2025 04:00:00 +0000

Medical Education; 09/01/2025
(AN 188364155); ISSN: 03080110
CINAHL Complete

Autonomous Neurosurgical Robots: Ethical Concerns in Informed Consent and Global Health Equity...Townsend A. The Ethics of Autonomous Neurosurgical Robots (ANRs). Bioethics;2025;39(5):456-459.

Mon, 01 Sep 2025 04:00:00 +0000

Bioethics; 09/01/2025
(AN 188364336); ISSN: 02699702
CINAHL Complete

Home care nurses' ethical compass in palliative decision-making processes.

Mon, 01 Sep 2025 04:00:00 +0000

Geriatric Nursing; 09/01/2025
• Explores ethical challenges home care nurses face in palliative care. • Offers insights on balancing guidelines with personal values in decision-making. • Emphasizes core ethics principles and practical guidance for global adaptation. • Highlights the role of home care nurses in life-prolonging treatment decisions. • Calls for recognizing nurses' key role in improving palliative care globally. This study explored home care nurses' experiences with shared decision-making regarding treatment and care for home-dwelling patients in the palliative phase, focusing on their perceptions of their role. An exploratory qualitative design was used to conduct and interpret four focus group interviews with 24 home care nurses from four municipalities, guided by Gadamer's hermeneutics. Two themes emerged: (1) Being captured between guidelines and personal values, highlighting the importance of covering one's back and the challenges of addressing a patient's ambivalence in decisions about life and death, and (2) Navigating the home care nurses' role, involving being caught in a network of blurry boundaries and sitting tight – understood as holding back one's views or actions even when a clear course seems evident – when decisions need to be made. This study highlights home care nurses' ethical challenges in shared decision-making. It suggests the core principles of healthcare ethics as a framework to support home care nurses in clarifying their roles and enhancing shared decision-making in palliative care.
(AN 188446252); ISSN: 01974572
CINAHL Complete

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

Sat, 30 Aug 2025 04:00:00 +0000

BMC Medical Ethics; 08/30/2025
(AN 187668126); ISSN: 14726939
CINAHL Complete

Embracing frameworks, moral courage, and reflection in the ethical decision-making process: Beyond impulse and spontaneity.

Fri, 01 Aug 2025 04:00:00 +0000

Journal of the American Dental Association (JADA); 08/01/2025
(AN 186922778); ISSN: 00028177
CINAHL Complete

Informed Consent Is Central Ethics Concern with Xenotransplantation Clinical Trials.

Fri, 01 Aug 2025 04:00:00 +0000

Medical Ethics Advisor; 08/01/2025
(AN 186754532); ISSN: 08860653
CINAHL Complete

Corpus-Based Evaluation of Decision-Making in Medical Ethics by Large Language Models...20th World Congress on Medical and Health Informatics (MEDINFO), August 9-13, 2025, Taipei, Taiwan.

Fri, 01 Aug 2025 04:00:00 +0000

Studies in Health Technology & Informatics; 08/01/2025
Assessing the ethical biases of large language models (LLMs) is crucial for their clinical application. To evaluate the ethical behavior of LLMs in clinical settings, we introduce a text corpus that focuses on ethical dilemmas. The corpus comprises 50 scenarios of clinical cases, each consisting of a clinical situation and options that impose ethical dilemmas. Each option is scored based on four ethical principles, enabling the evaluation of the ethical decision-making capabilities of LLMs based on their decision trajectories. The GPT-4 and GEMINI LLMs demonstrate significantly higher ethical scores than random selection across all ethical principles. Furthermore, both LLMs demonstrate adaptability to instructions for specific cases, revealing ethical vulnerabilities because they comply with ethically undesirable instructions. Future corpus expansion may allow evaluating diverse cultural and institutional contexts, thereby enhancing ethical evaluation.
(AN 187334872); ISSN: 09269630
CINAHL Complete

Informed consent in genetic and genomic studies in Sub-Saharan Africa: a systematic review of bioethical issues.

Sat, 19 Jul 2025 04:00:00 +0000

BMC Medical Ethics; 07/19/2025
(AN 186782224); ISSN: 14726939
CINAHL Complete

The moral labour of food purchase decision-making - an ethnographic study among families in Denmark

Thu, 17 Jul 2025 00:00:00 +0000

Appetite. 2025 Jul 15:108234. doi: 10.1016/j.appet.2025.108234. Online ahead of print.

ABSTRACT

Understanding families' food purchase decision-making is essential to developing successful interventions to promote healthier behaviours. Several factors can influence the foods people purchase. However, knowledge about how parents handle dilemmas in food purchase decisions and how these decisions affect families' food purchases is scarce. This study explores families' food purchase decisions in supermarkets and illustrates how parents navigate the tension between their values and contextual and situational circumstances (e.g. family situation). We conducted 37 semi-structured, shop-along, and photo-elicited interviews with parents from fifteen families with children ranging from 0 to 19 years of age (September 2022-January 2023). We used an abductive analytical approach to investigate the role of conscience and morality in our empirical findings. We applied the theoretical concept of moral labour to examine how individuals navigate the discomfort associated with guilt or a guilty conscience, which arises from conflicts or dissonance of their values when making food purchases in supermarkets. Food purchase decisions were influenced by moral considerations related to animal welfare, climate, parental responsibility, and good and healthy food. However, product availability and presentation, price, and the parent-child interaction, as well as contextual and situational circumstances, could challenge parents' values, triggering moral labour. The study illustrates how parents performed moral labour, e.g., minimising the health impact, to reconcile with negative feelings of conflicting values. Future intervention studies should consider focusing on supportive food environments over individual behaviour changes to minimise the potential moral labour among parents from such initiatives.

PMID:40675455 | DOI:10.1016/j.appet.2025.108234

Third-Party Consent To Medical Treatment in Malaysia: A Critical Analysis from Ethical and Malaysian Legal Perspectives

Thu, 10 Jul 2025 00:00:00 +0000

Health Care Anal. 2025 Jul 10. doi: 10.1007/s10728-025-00531-4. Online ahead of print.

ABSTRACT

Third-party consent, while common in medical practice, presents complex ethical dimensions and intricate legal connotations. In Malaysia, the absence of comprehensive legislation governing third-party consent for adults lacking decision-making capacity due to temporary conditions creates profound dilemmas for healthcare professionals. This article critically examines these challenges through a compelling case study of an 18-year-old female with respiratory failure who required immediate invasive intervention but did not receive consent from her mother. Despite medical urgings and a favourable prognosis, the mother's refusal highlights the difficulties healthcare providers face when navigating between their ethical obligations to act in the patient's best interests and the patient's family's wishes. Employing a dual analysis from ethical and Malaysian legal perspectives, the study explores the tensions between universal medical ethics-particularly the principles of autonomy, beneficence, and non-maleficence-and the existing Malaysian legal framework. It reveals contradictions between the Malaysian Medical Council's guidelines, which appear to grant decision-making authority to family members, and English common law principles that emphasise acting in the patient's best interests, especially in emergency situations. This inconsistency generates significant uncertainty for healthcare professionals, potentially compromising patient care and exposing physicians to litigation when acting without explicit consent. Through systematic examination of both emergency and non-emergency scenarios, the article underscores the urgent need for comprehensive legislation in Malaysia to address third-party consent, particularly for patients not covered by the Mental Health Act 2001. It advocates for laws that clearly differentiate between emergency and non-emergency situations, delineate the authority of relatives and legal guardians, and align with international practices and fundamental medical ethics principles. By harmonising legal statutes with ethical imperatives, Malaysia can resolve the contradictions that currently jeopardise patient welfare and physician security. These findings have important implications for healthcare policy development and clinical practice, emphasising the necessity for ethical and legal coherence in medical care in Malaysia.

PMID:40638036 | DOI:10.1007/s10728-025-00531-4

Epistemic Authority in "Risk-Making": Ethical Dimensions of Surrogate Decision-Making for Patients with Disorders of Consciousness

Wed, 09 Jul 2025 00:00:00 +0000

AJOB Neurosci. 2025 Jul-Sep;16(3):146-149. doi: 10.1080/21507740.2025.2519438. Epub 2025 Jul 9.

NO ABSTRACT

PMID:40632134 | DOI:10.1080/21507740.2025.2519438

Unveiling Bias in Distilled Artificial Intelligence Models: Ethical and Clinical Impacts on Decision-Making and Medical Auditing.

Tue, 08 Jul 2025 04:00:00 +0000

Journal of Medical Systems; 07/08/2025
(AN 186463872); ISSN: 01485598
CINAHL Complete

Unveiling Bias in Distilled Artificial Intelligence Models: Ethical and Clinical Impacts on Decision-Making and Medical Auditing

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

J Med Syst. 2025 Jul 8;49(1):95. doi: 10.1007/s10916-025-02230-y.

NO ABSTRACT

PMID:40624212 | DOI:10.1007/s10916-025-02230-y

Inappropriate Delays in Surrogate Decision-Making: Thinking Through Strategies and Obligations for Addressing This Common Ethical Dilemma

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

Am J Bioeth. 2025 Jul;25(7):169-171. doi: 10.1080/15265161.2025.2509919. Epub 2025 Jul 7.

NO ABSTRACT

PMID:40622785 | DOI:10.1080/15265161.2025.2509919

Breathing Room: Ethical Uncertainty in Surrogate Decision-Making for Tracheostomy

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

Am J Bioeth. 2025 Jul;25(7):165-166. doi: 10.1080/15265161.2025.2510137. Epub 2025 Jul 7.

NO ABSTRACT

PMID:40622782 | DOI:10.1080/15265161.2025.2510137

Ethical decision making in airway management: a difficult Airway Society position statement on good practice

Fri, 04 Jul 2025 00:00:00 +0000

BJA Open. 2025 Jun 19;15:100416. doi: 10.1016/j.bjao.2025.100416. eCollection 2025 Sep.

ABSTRACT

Practitioners involved in airway management must balance ethical issues in their practice. Ethical tensions exist because clinicians must maintain clinical standards while maximising skill development, exploring advances in airway practice, and incorporating new learning to benefit future patients. Balancing the benefits and risks to the patient and choosing the right techniques in the right situations and with the right level of patient understanding and respect for patient autonomy can be challenging. These challenges are shared by airway practitioners from many professional backgrounds; however, this document has been developed specifically to support anaesthetists in their airway management decisions, and for simplicity, the term 'anaesthetists' will be used throughout the document. However, the ethical considerations will have relevance to all airway practitioners. Practice combined with training is central to professional development. Most patients are aware that training is entwined with care and trust anaesthetists to deliver this safely. Trainers should use airway teaching methods appropriate to the trainee's needs and skills. Informed consent is required for airway management, and the level of detail should be proportionate to the risks involved. Patients have individual preferences and appreciation of risks, so these conversations must be individualised. Anaesthetists should support the development of new airway devices and techniques. New methods must be assessed within governance structures, and it may be appropriate to collect data or feedback as part of the introduction to practice. Ethical practice requires doing what is best, doing it openly, honestly, and in patients' interests. The modern ethical and legal landscape has emphasised patient information, discussion, and documentation. We hope this position statement provides guidance, structure, and clarity for the benefit of our patients and our specialty.

PMID:40612241 | PMC:PMC12221679 | DOI:10.1016/j.bjao.2025.100416

Distance caregiving using smart home technologies: balancing ethical priorities in family decision-making by only children.

Thu, 03 Jul 2025 04:00:00 +0000

BMC Medical Ethics; 07/03/2025
(AN 186373541); ISSN: 14726939
CINAHL Complete

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