ethique_consentment_aptitutde

Ethics of using generative pretrained transformer and artificial intelligence systems for patient prior authorizations.

Wed, 01 May 2024 04:00:00 +0000

Journal of the American Academy of Dermatology; 05/01/2024
(AN 176561942); ISSN: 01909622
CINAHL Complete

Interventions to improve ethical decision-making skills in nursing students: A systematic review

Tue, 16 Apr 2024 08:32:23 +0000

Author Names: Kasikci M.,Yildirim Z.

Database Source: Embase Daily Updates

Journal Title: Nursing ethics

Article Title: Interventions to improve ethical decision-making skills in nursing students: A systematic review

Year: 2024

Issue:

Volume:

Abstract: BACKGROUND: Interventions to improve ethical decision-making are available in nursing education. Evidence of its effectiveness is essential. <br/>OBJECTIVE(S): This review examined the effectiveness of interventions to improve nursing students' ethical decision-making skills. <br/>METHOD(S): A structured search was performed in Google Scholar, Web of Science, Science Direct, Pubmed, Scopus, Cochrane Library, Elsevier, CINAHL EBSCO, and ULAKBIM. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instruments (JBI-MAStARI) was used to assess the quality of studies. ETHICAL CONSIDERATIONS: Ethical approval was not required for this systematic review. FINDINGS: The final review was composed of six studies of published between January 2013 and 2023. Nine different teaching methods applied to students. Although the importance of ethical decision-making skills in solving ethical problems that nurses may encounter at any time is known, it is thought that there is a lack of data in the literature in the last 10 years. The last 10 years were chosen as this aims to provide a review based on the most current, relevant and quality information. The review indicated that all of the teaching methods improved ethical decision-making. <br/>CONCLUSION(S): Different teaching methods can be used in the nursing education curriculum to meet the learning needs of nursing students in ethical decision-making.

Reciprocity in ambiguous situations: Default psychological strategies underlying ambiguity resolution in moral decision-making

Thu, 04 Apr 2024 00:00:00 +0000

PLoS One. 2024 Apr 4;19(4):e0300886. doi: 10.1371/journal.pone.0300886. eCollection 2024.

ABSTRACT

When deciding whether to reciprocate trust, people are typically strongly influenced by how much trust their interaction partner has originally shown them. If a partner has placed a lot of trust in you, there is a strong motivation to reciprocate, and indeed this factor often outweighs pro-self considerations to maximize one's own financial payout. However, one important unanswered question in this regard is what people decide to do when this prior information is ambiguous; that is, when they do not know for sure exactly how trusting their partner has been. How then do people decide to reciprocate? This study utilizes a novel version of the Trust Game to directly address this question. Here, we develop, and validate, a computational model-based approach to quantify and categorize how participants assessed the trustworthiness of an unfamiliar partner when making reciprocity decisions. We find that participants spontaneously use their prior experience about the trustingness of game partners in general to inform their reciprocity decisions, even when they had the opportunity to strategically assume that their new, unfamiliar, partners were untrusting, and hence could have justified lower reciprocation rates.

PMID:38574089 | DOI:10.1371/journal.pone.0300886

Ethical considerations for requesting waivers of parental consent for research with minor adolescents who identify as LGBTQ+.

Mon, 01 Apr 2024 04:00:00 +0000

Ethics & Behavior; 04/01/2024
Parental consent poses challenges to needed research with adolescents who identify as lesbian, gay, bisexual, transgender, queer and/or questioning (LGBTQ+) and are at heightened risk for negative health outcomes. Obtaining parental consent in studies focused on LGBTQ+ issues can prove arduous if adolescents have not yet disclosed their identity or have unsupportive guardians. Institutional Review Boards (IRBs) may be hesitant to grant waivers of parental consent, yet research suggests that studies requiring parental consent deter the participation of adolescents who identify as LGBTQ+. In this article, ethical considerations regarding waivers of parental consent in the context of the American Psychological Association's (APA) general ethical principles are reviewed and recommendations for psychological researchers seeking waivers of parental consent are offered. A vignette is used to demonstrate a question-and-answer guide to help determine if a waiver of parental consent is ethically justified.
(AN 175394026); ISSN: 10508422
CINAHL Complete

Assessing the ethics of prior authorization denials and step therapy policies in dermatology.

Mon, 01 Apr 2024 04:00:00 +0000

Journal of the American Academy of Dermatology; 04/01/2024
(AN 175913273); ISSN: 01909622
CINAHL Complete

Ethical Justifications for Waiving Informed Consent for a Perianal Swab in Critical Burn Care Research.

Mon, 01 Apr 2024 04:00:00 +0000

American Journal of Bioethics; 04/01/2024
(AN 176244175); ISSN: 15265161
CINAHL Complete

Ethical Reasoning as a Core Nurse Leader Competency: Maximizing Strategic Decision-Making and Operational Outcomes.

Mon, 01 Apr 2024 04:00:00 +0000

Nurse Leader; 04/01/2024
Nurse leaders practice across an exceedingly complex and dynamic healthcare landscape, requiring the highest levels of ethical reasoning, engagement, and leadership skills to guide decision-making. Nurse leaders shape the organizational climate and conditions supporting ethical practice and must identify ethical dilemmas, explore individual perspectives through multiple lenses, and make strategic decisions consistent with personal, professional, and organizational values. This manuscript educates nurse leaders on the critical adaptive competency of strategic ethical reasoning to guide just and ethical decision-making for their organizations and communities. We recommend nurse leaders use ethical reasoning to drive strategic decision-making and cultivate ethical practice environments.
(AN 176230566); ISSN: 15414612
CINAHL Complete

Ethical Justifications for Waiving Informed Consent for a Perianal Swab in Critical Burn Care Research

Tue, 26 Mar 2024 00:00:00 +0000

Am J Bioeth. 2024 Apr;24(4):110-113. doi: 10.1080/15265161.2024.2308133. Epub 2024 Mar 26.

NO ABSTRACT

PMID:38529966 | DOI:10.1080/15265161.2024.2308133

On the ethics of informed consent in genetic data collected before 1997

Wed, 13 Mar 2024 00:00:00 +0000

Nature. 2024 Mar;627(8003):271. doi: 10.1038/d41586-024-00762-w.

NO ABSTRACT

PMID:38472325 | DOI:10.1038/d41586-024-00762-w

Ethics of social media consent forms

Thu, 07 Mar 2024 00:00:00 +0000

J Am Acad Dermatol. 2024 Mar 5:S0190-9622(24)00443-2. doi: 10.1016/j.jaad.2024.02.043. Online ahead of print.

NO ABSTRACT

PMID:38452819 | DOI:10.1016/j.jaad.2024.02.043

The Utilitarian Virtual Self - Using Embodied Personalized Avatars to Investigate Moral Decision-Making in Semi-Autonomous Vehicle Dilemmas

Mon, 04 Mar 2024 00:00:00 +0000

IEEE Trans Vis Comput Graph. 2024 Mar 4;PP. doi: 10.1109/TVCG.2024.3372121. Online ahead of print.

ABSTRACT

Embodied personalized avatars are a promising new tool to investigate moral decision-making by transposing the user into the "middle of the action" in moral dilemmas. Here, we tested whether avatar personalization and motor control could impact moral decision-making, physiological reactions and reaction times, as well as embodiment, presence and avatar perception. Seventeen participants, who had their personalized avatars created in a previous study, took part in a range of incongruent (i.e., harmful action led to better overall outcomes) and congruent (i.e., harmful action led to trivial outcomes) moral dilemmas as the drivers of a semi-autonomous car. They embodied four different avatars (counterbalanced - personalized motor control, personalized no motor control, generic motor control, generic no motor control). Overall, participants took a utilitarian approach by performing harmful actions only to maximize outcomes. We found increased physiological arousal (SCRs and heart rate) for personalized avatars compared to generic avatars, and increased SCRs in motor control conditions compared to no motor control. Participants had slower reaction times when they had motor control over their avatars, possibly hinting at more elaborate decision-making processes. Presence was also higher in motor control compared to no motor control conditions. Embodiment ratings were higher for personalized avatars, and generally, personalization and motor control were perceptually positive features. These findings highlight the utility of personalized avatars and open up a range of future research possibilities that could benefit from the affordances of this technology and simulate, more closely than ever, real-life action.

PMID:38437115 | DOI:10.1109/TVCG.2024.3372121

Capacities to Refuse Treatment: A Reply...Cong, Y. 2022. Why not jump out of decision-making capacity? The American Journal of Bioethics 22 (11):100–2.

Fri, 01 Mar 2024 05:00:00 +0000

American Journal of Bioethics; 03/01/2024
(AN 175640480); ISSN: 15265161
CINAHL Complete

Informed Consent: A Patient's Right to Information and a Nurse's Legal and Ethical Obligation.

Fri, 01 Mar 2024 05:00:00 +0000

Journal of the New York State Nurses Association; 03/01/2024
Purpose: The purpose of this article is to analyze the extent to which there is a requirement for nurses to obtain a patient's informed consent by comparing and contrasting the role of the nurse as a provider of treatment and care versus the role of the nurse as a witness to the informed consent process and procedure. Rationale: The requirement for licensed healthcare providers, including registered professional nurses, to obtain informed consent prior to procedures that invade the integrity of the patient's body or that might be otherwise considered a battery, is addressed by healthcare law and ethics. It is important for nurses to understand the legal and ethical mandates and rational behind the principles of informed consent so that they will be in full compliance with duties owed to the patient under law and ethics. Position Statement: The legal and ethical requirement to obtain a patient's informed consent is significantly relevant to nursing practice and care. This article will discuss the purpose of informed consent, the process of informed consent, the circumstances under which nursing care requires a patient's informed consent, and the implications of the informed consent procedure for nurses when approaching all aspects of patient care. Conclusion: The principles, processes, and procedures of informed consent should underlie a nurse's approach to all nursing care procedures. Informed consent should not be a limited, automatous process that is only relevant to surgical or research procedures, but rather a way of facilitating a patient's meaningful decision-making in all aspects of treatment and care.
(AN 175587065); ISSN: 00287644
CINAHL Complete

Ethical Considerations with After-the-Fact Informed Consent.

Fri, 01 Mar 2024 05:00:00 +0000

Medical Ethics Advisor; 03/01/2024
(AN 175701706); ISSN: 08860653
CINAHL Complete

Prenatally-diagnosed renal failure: an ethical framework for decision-making.

Fri, 01 Mar 2024 05:00:00 +0000

Journal of Perinatology; 03/01/2024
The Children's Hospital Working Group has developed an ethical framework to guide patient care and research for prenatally diagnosed severe renal anomalies. It identifies ethical challenges in communication, timing of decisions and scarce resources. Key elements include shared decision-making, establishing a trusting relationship, and managing disagreement. The ethical framework will be used to develop a clinical pathway that operationalizes the key values of trust, honesty, transparency, beneficence, nonmaleficence, respecting parental authority, professional integrity, and justice.
(AN 175932286); ISSN: 07438346
CINAHL Complete

Specific Trends in Pediatric Ethical Decision-Making: An 18-Year Review of Ethics Consultation Cases in a Pediatric Hospital

Wed, 28 Feb 2024 00:00:00 +0000

HEC Forum. 2024 Feb 28. doi: 10.1007/s10730-024-09524-7. Online ahead of print.

ABSTRACT

This is a qualitative examination of ethics consultation requests, outcomes, and ethics committee recommendations at a tertiary/quaternary pediatric hospital in the U.S. The purpose of this review of consults over an 18-year period is to identify specific trends in the types of ethical dilemmas presented in our pediatric setting, the impact of consultation and committee development on the number and type of consults provided, and any clinical features and/or challenges that emerged and contributed to the nature of ethical situations and dilemmas. Furthermore, in reviewing clinical ethics consultation trends for nearly two decades, we can identify topic areas for further ethics education and training for ethics consultants, ethics committee members, and pediatric healthcare teams and professionals based on our experiences. Our study with nearly two decades of data prior to the COVID-19 pandemic can serve as groundwork for future comparisons of consultation requests and ethics support for pediatric hospitals prior to, during, and following a pandemic.

PMID:38416336 | DOI:10.1007/s10730-024-09524-7

Trust-Building: Why Virtual Formats Threaten the Moral Ends of Surgical Informed Consent

Mon, 26 Feb 2024 00:00:00 +0000

Ann Surg. 2024 Feb 26. doi: 10.1097/SLA.0000000000006252. Online ahead of print.

ABSTRACT

The COVID-19 pandemic forced a wide range of medical practices to virtual formats, including the preoperative informed consent practice. However, virtual informed consent persists despite the pandemic largely considered resolved. The continued use of virtual formats relies on a problematic "information-transfer" model of informed consent. We suggest that a "trust-building" model of consent as a better conceptualization of what is occurring during the consent process. Highlighting how virtual formats might fail to fulfill this fuller understanding of consent on both interpersonal and systemic levels, we offer up an ethical structure for physicians to navigate this novel virtual space.

PMID:38407277 | DOI:10.1097/SLA.0000000000006252

Balancing ethical principles in dermatology: Disclosing clinical trial underrepresentation during informed consent

Sat, 24 Feb 2024 00:00:00 +0000

Clin Dermatol. 2024 Feb 23:S0738-081X(24)00037-3. doi: 10.1016/j.clindermatol.2024.02.004. Online ahead of print.

NO ABSTRACT

PMID:38401698 | DOI:10.1016/j.clindermatol.2024.02.004

Ethical Issues in Clinical Decision-Making about Involuntary Psychiatric Treatment: A Scoping Review

Fri, 23 Feb 2024 00:00:00 +0000

Healthcare (Basel). 2024 Feb 9;12(4):445. doi: 10.3390/healthcare12040445.

ABSTRACT

In mental health and psychiatric care, the use of involuntary psychiatric treatment for people with mental disorders is still a central and contentious issue. The main objective of this scoping review was to map and systematize the literature on ethical issues in clinical decision-making about involuntary psychiatric treatment. Five databases (Embase, PsycINFO, CINAHL, Medline, and Scopus) were searched for articles on this topic. Out of a total of 342 articles found, 35 studies from 14 countries were included based on the selection criteria. The articles were analyzed using the inductive content analysis approach. The following main categories were identified: (1) ethical foundations that guide clinical decision-making; (2) criteria for involuntary psychiatric treatment; (3) gaps, barriers, and risks associated with involuntary psychiatric treatment; (4) strategies used to reduce, replace, and improve the negative impact of involuntary treatment; and (5) evidence-based recommendations. Most of the selected articles discuss the logic underlying involuntary treatment of the mentally ill, exploring ethical principles such as autonomy, beneficence, non-maleficence, or justice, as well as how these should be properly balanced. During the process of involuntary psychiatric admission, there was a notable absence of effective communication and a significant power imbalance that disenfranchised those seeking services. This disparity was further intensified by professionals who often use coercive measures without a clear decision-making rationale and by family members who strongly depend on hospital admission. Due to the pluralistic and polarized nature of opinions regarding legal capacity and the complexity and nuance of involuntary admission, further studies should be context-specific and based on co-production and participatory research.

PMID:38391820 | PMC:PMC10888148 | DOI:10.3390/healthcare12040445

Adolescent assent in research: a relational ethics approach

Tue, 20 Feb 2024 00:00:00 +0000

Indian J Med Ethics. 2023 Oct-Dec;VIII(4):313-317. doi: 10.20529/IJME.2023.048.

ABSTRACT

Researchers often neglect adolescents' willingness to participate in research. The granting of permission by parents is sometimes not in accordance with the unwillingness of adolescents. Relational ethics is the right approach to overcome inconsistencies between legal and ethical agreements in granting parental permission and adolescent's assent. This is because relational ethics is based on building relationships among many parties. The focus of this case study is to improve understanding of the assent of adolescents through intensive study of research conflict, reinforced using existing research and to understand how relational ethics can be used as an approach in decision-making, especially in conflicts between parental permission and assent from adolescents.

PMID:38374678 | DOI:10.20529/IJME.2023.048

Ethical Issues in Clinical Decision-Making about Involuntary Psychiatric Treatment: A Scoping Review.

Thu, 15 Feb 2024 05:00:00 +0000

Healthcare (2227-9032); 02/15/2024
(AN 175645619); ISSN: 22279032
CINAHL Complete

Surveying the Moral Landscape: How Ethical Frameworks Influence the Structure of Return-to-Sport Decision Making

Wed, 14 Feb 2024 00:00:00 +0000

J Orthop Sports Phys Ther. 2024 Apr;54(4):1-4. doi: 10.2519/jospt.2024.12310.

ABSTRACT

SYNOPSIS: Similar to all areas of health care, sports medicine has ethical considerations when making decisions-return to sport being one. Despite a general consensus on criteria to determine when an athlete is ready to return to sport, there are various scenarios that clinicians encounter that may not fall into a clear "yes" or "no" decision. These scenarios leave the clinician asking what is the "right" decision in a given circumstance? A line of questioning that invokes a moral dimension in supporting athletes when they are returning to sport. To address the moral aspect of a clinical decision, ethical frameworks and theories can guide decisions and resolve ethical dilemmas. The aim of this Viewpoint is to briefly describe 4 ethical frameworks and explore how they might apply in a clinical scenario to guide different ethical analyses and influence the final decision. J Orthop Sports Phys Ther 2024;54(4):1-4. Epub 14 February 2024. doi:10.2519/jospt.2024.12310.

PMID:38353482 | DOI:10.2519/jospt.2024.12310

Ethical considerations and decision making in opioid prescribing for chronic pain: A case study in rheumatology practice

Thu, 08 Feb 2024 00:00:00 +0000

J Am Assoc Nurse Pract. 2024 Feb 8. doi: 10.1097/JXX.0000000000001002. Online ahead of print.

ABSTRACT

Dilemmas regarding opioid prescribing for chronic pain frequently occur within health care settings. The ethical principles of autonomy, beneficence, nonmaleficence, and justice, as well as the principles of care ethics, can assist in addressing these opioid-related dilemmas. The purpose of this clinical case study is to provide a case study highlighting an opioid prescribing dilemma and then identify opioid-related transition considerations; address ethical questions that nurse practitioners (NPs) may encounter in clinical practice when providing care for individuals living with chronic pain who may need or use a prescribed opioid medication; and draw on the ethical principles and care ethics to provide guidance for NPs who face these challenging issues.

PMID:38330235 | DOI:10.1097/JXX.0000000000001002

ChatGPT: aid to medical ethics decision making?

Mon, 05 Feb 2024 00:00:00 +0000

Anaesthesiologie. 2024 Mar;73(3):186-192. doi: 10.1007/s00101-024-01385-6.

ABSTRACT

BACKGROUND: Physicians have to make countless decisions every day. The medical, ethical and legal aspects are often intertwined and subject to change over time. Involving an ethics committee or arranging an ethical consultation are examples of potential aids to decision making. Whether and how artificial intelligence (AI) and the large language model (LLM) of the company OpenAI (San Francisco, CA, USA), known under the name ChatGPT, can also help and support ethical decision making is increasingly becoming a matter of controversial debate.

MATERIAL AND METHODS: Based on a case example, in which a female physician is confronted with ethical and legal issues and presents these to ChatGPT to come up with answers, the first indications of the strengths and weaknesses are ascertained.

CONCLUSION: Due to the rapid technical development and access to ever increasing quantities of data, the utilization should be closely observed and evaluated.

PMID:38315183 | DOI:10.1007/s00101-024-01385-6

Probability, measurement mismatches, and sacrificial moral decision-making.

Thu, 01 Feb 2024 05:00:00 +0000

Cognition; 02/01/2024
(AN 174317832); ISSN: 00100277
CINAHL Complete

Conspiracy theories, clinical decision‐making, and need for bioethics debate: A response to Stout.

Thu, 01 Feb 2024 05:00:00 +0000

Bioethics; 02/01/2024
Although people who endorse conspiracy theories related to medicine often have negative attitudes toward particular health care measures and may even shun the healthcare system in general, conspiracy theories have received rather meager attention in bioethics literature. Consequently, and given that conspiracy theorizing appears rather prevalent, it has been maintained that there is significant need for bioethics debate over how to deal with conspiracy theories. While the proposals have typically focused on the effects that unwarranted conspiracy theories have in the public health context, Nathan Stout's recent argument concentrates on the impacts that such theories have at the individual level of clinical decision‐making. In this article, I maintain that duly acknowledging the impacts of conspiracy theories that raise Stout's concern does not require bioethics debate over the proper response to the influence of conspiracy theories in healthcare. Having evaluated two possible objections, I conclude by briefly clarifying the purported import of the response to Stout.
(AN 174779890); ISSN: 02699702
CINAHL Complete

Evolving Attitudes on Ethics of Adolescent Self-Consent.

Thu, 01 Feb 2024 05:00:00 +0000

Medical Ethics Advisor; 02/01/2024
(AN 175072620); ISSN: 08860653
CINAHL Complete

Ethical and legal challenges of medical AI on informed consent: China as an example

Fri, 19 Jan 2024 00:00:00 +0000

Dev World Bioeth. 2024 Jan 19. doi: 10.1111/dewb.12442. Online ahead of print.

ABSTRACT

The escalating integration of Artificial Intelligence (AI) in clinical settings carries profound implications for the doctrine of informed consent, presenting challenges that necessitate immediate attention. China, in its advancement in the deployment of medical AI, is proactively engaging in the formulation of legal and ethical regulations. This paper takes China as an example to undertake a theoretical examination rooted in the principles of medical ethics and legal norms, analyzing informed consent and medical AI through relevant literature data. The study reveals that medical AI poses fundamental challenges to the accuracy, adequacy, and objectivity of information disclosed by doctors, alongside impacting patient competency and willingness to give consent. To enhance adherence to informed consent rules in the context of medical AI, this paper advocates for a shift towards a patient-centric information disclosure standard, the restructuring of medical liability rules, the augmentation of professional training, and the advancement of public understanding through educational initiatives.

PMID:38240080 | DOI:10.1111/dewb.12442

Compliance with research ethics in epidemiological studies targeted to conflict-affected areas in Western Ethiopia: validity of informed consent (VIC) by information comprehension and voluntariness (ICV).

Thu, 18 Jan 2024 05:00:00 +0000

BMC Medical Ethics; 01/18/2024
(AN 174875786); ISSN: 14726939
CINAHL Complete

Informed Consent to Psychedelic-Assisted Psychotherapy: Ethical Considerations

Wed, 17 Jan 2024 00:00:00 +0000

Can J Psychiatry. 2024 Jan 17:7067437231225937. doi: 10.1177/07067437231225937. Online ahead of print.

NO ABSTRACT

PMID:38232948 | DOI:10.1177/07067437231225937

Broad consent for biobank research in South Africa - Towards an enabling ethico-legal framework

Fri, 05 Jan 2024 00:00:00 +0000

Glob Bioeth. 2023 Dec 20;35(1):2288331. doi: 10.1080/11287462.2023.2288331. eCollection 2024.

ABSTRACT

Broad consent is permitted by the South African National Department of Health Ethics Guidelines but appears to be prohibited by section 13(1) of the Protection of Personal Information Act 4 of 2013. Additionally, the Act mandates that all personal data (including biobank sample data) be collected for lawful, explicit, and clearly defined purposes. There is possibility for ambiguity in interpretation because of this discrepancy between the two instruments. Given the association between the transfer of samples and data, the long-term nature of biobanking, which makes it impractical to provide too much or enough information because it is simply not available at the time of sample collection, and the various ways that the Protection of Personal Information Act 4 of 2013 have been interpreted, we aim to demonstrate that South Africa's current regulatory framework should appropriately permit broad consent use for biobank research where the transfer of samples and their associated data are contemplated. In summary, the proposed amendments include removing regulatory ambiguity regarding broad consent use, ensuring adequate safeguards for research participants by specifying rules for data access and personal information processing, and incorporating consent form information requirements into the national Consent Template.

PMID:38179086 | PMC:PMC10763822 | DOI:10.1080/11287462.2023.2288331

Artificial intelligence in clinical decision‐making: Rethinking personal moral responsibility.

Mon, 01 Jan 2024 05:00:00 +0000

Bioethics; 01/01/2024
Artificially intelligent systems (AISs) are being created by software developing companies (SDCs) to influence clinical decision‐making. Historically, clinicians have led healthcare decision‐making, and the introduction of AISs makes SDCs novel actors in the clinical decision‐making space. Although these AISs are intended to influence a clinician's decision‐making, SDCs have been clear that clinicians are in fact the final decision‐makers in clinical care, and that AISs can only inform their decisions. As such, the default position is that clinicians should hold responsibility for the outcomes of the use of AISs. This is not the case when an AIS has influenced a clinician's judgement and their subsequent decision. In this paper, we argue that this is an imbalanced and unjust position, and that careful thought needs to go into how personal moral responsibility for the use of AISs in clinical decision‐making should be attributed. This paper employs and examines the difference between prospective and retrospective responsibility and considers foreseeability as key in determining how personal moral responsibility can be justly attributed. This leads us to the view that moral responsibility for the outcomes of using AISs in healthcare ought to be shared by the clinical users and SDCs.
(AN 174410986); ISSN: 02699702
CINAHL Complete

Ethical Decision-Making with Deprescribing for Older Adults.

Mon, 01 Jan 2024 05:00:00 +0000

Medical Ethics Advisor; 01/01/2024
The article focuses on the ethical issues surrounding deprescribing for older adults with dementia, as highlighted in a study that surveyed primary care physicians regarding hypothetical cases where deprescribing decisions needed to be made. It study identified factors related to ethical and pragmatic concerns, with physicians ranking patient or family-reported benefit and lack of evidence of benefit as the two major barriers to deprescribing in both cases.
(AN 174390272); ISSN: 08860653
CINAHL Complete

Ethical leadership and TMT decision-making of corporate social responsibility - a perspective of self-determination theory

Mon, 25 Dec 2023 00:00:00 +0000

Front Psychol. 2023 Dec 8;14:1268091. doi: 10.3389/fpsyg.2023.1268091. eCollection 2023.

ABSTRACT

This study examines the impact of ethical leadership on top management team (TMT) decision-making regarding corporate social responsibility (CSR), considering the mediating role of TMT passion and the moderating role of performance stress. The study distinguishes between TMT harmonious and obsessive work passion and categorizes CSR as proactive and reactive. The findings reveal the following: (1) Ethical leadership positively influences proactive CSR, with TMT harmonious work passion acting as a positive mediator and TMT obsessive work passion playing a negative mediating role; (2) ethical leadership positively affects reactive CSR, with both TMT harmonious and obsessive work passion serving as positive mediators; (3) performance stress diminishes the impact of ethical leadership on TMT harmonious work passion; however, it amplifies the effect on TMT obsessive work passion. Consequently, the mediating effect of TMT harmonious work passion weakens, while the mediating effect of TMT obsessive work passion strengthens. This study emphasizes the significant role of TMT in CSR strategic decision-making and proposes a novel mediating mechanism through which ethical leadership drives CSR decision-making by considering TMT work passion. These findings reconcile the theoretical-practical conflict and have important theoretical and practical implications for enterprises in fulfilling their social responsibility.

PMID:38145000 | PMC:PMC10748587 | DOI:10.3389/fpsyg.2023.1268091

Deciding for Patients Who Have Lost Decision-Making Capacity -- Finding Common Ground in Medical Ethics.

Thu, 21 Dec 2023 05:00:00 +0000

New England Journal of Medicine; 12/21/2023
(AN 174732481); ISSN: 00284793
CINAHL Complete

Deciding for Patients Who Have Lost Decision-Making Capacity - Finding Common Ground in Medical Ethics

Mon, 18 Dec 2023 00:00:00 +0000

N Engl J Med. 2023 Dec 21;389(25):2309-2312. doi: 10.1056/NEJMp2308484. Epub 2023 Dec 16.

NO ABSTRACT

PMID:38108394 | DOI:10.1056/NEJMp2308484

Probability, measurement mismatches, and sacrificial moral decision-making

Fri, 15 Dec 2023 00:00:00 +0000

Cognition. 2024 Feb;243:105692. doi: 10.1016/j.cognition.2023.105692. Epub 2023 Dec 14.

ABSTRACT

Despite the importance of uncertainty in decision-making, few published studies have examined how individuals make moral judgments under uncertainty. Across four experiments (N = 445), we examined whether a relatively small shift in probability affected participants' judgments of both moral acceptability and choice. Overall, reading dilemmas where the characters were either certain or likely to die, the probability of the sacrificed individual and the group at risk dying both had independent effects on participants' responses. That is, participants were more accepting of sacrificing the individual if they were not certain to die, but less accepting if the group was only likely to die when the individual was not sacrificed. Furthermore, a number of participants made acceptability ratings that did not match the action they endorsed, either finding the sacrificial decision more acceptable but refusing to make it, or choosing the sacrificial decision while viewing it as less acceptable. Many participants also stated that this was because they recognised a crucial difference between what they viewed as morally acceptable in a dilemma and what they were actually willing to do. Such mismatches may reflect the sensitivity and complexity of the moral principles that individuals employ during their moral decision-making.

PMID:38101081 | DOI:10.1016/j.cognition.2023.105692

Ethical considerations for genetic research in low-income countries: perceptions of informed consent, data sharing, and expectations in Nicaragua

Tue, 05 Dec 2023 00:00:00 +0000

Eur J Hum Genet. 2023 Dec 5. doi: 10.1038/s41431-023-01505-7. Online ahead of print.

ABSTRACT

Genetic research presents numerous ethical, legal, and social implications (ELSI), particularly when the research involves collaborations between investigators in high and low-income countries. Some ELSI issues are universal, and others are specific to context and culture. This study investigates perceptions of genetic research in Nicaragua, Central America, where local and U.S. based researchers have collaborated for over a decade. A total of 43 residents from northwestern Nicaragua, a region with high mortality rates attributed to chronic kidney disease of non-traditional causes (CKDnt), were interviewed, including research participants in ongoing studies (n = 36), health professionals (n = 3), labor leaders (n = 2), and family members of research participants (n = 2). Questions focused on informed consent, data-sharing, and post-study expectations. Audio recordings of interviews conducted in Spanish were transcribed and translated into English. English transcripts were coded and analyzed using NVivo 12 software. The lack of familiarity with terms in the consent form presented a barrier to participant comprehension of key elements of the genetic research study, raising concerns about the validity of informed consent. Research participants often viewed their participation as access to health care. Health professionals emphasized the importance of long-term partnerships between foreign-based researchers and local health institutions. Leaders and family members recommended that they be informed of research studies and allowed the opportunity to consent, as they felt the benefits and risks of research also apply to them. Our findings identified genetic research practices to be improved upon in order to be more responsive to the contextual realities of collaborators living in low-resource settings.

PMID:38052907 | DOI:10.1038/s41431-023-01505-7

Primum Non Nocere: TAVR, Frailty, and Moral Decision Making

Sat, 02 Dec 2023 00:00:00 +0000

Can J Cardiol. 2024 Mar;40(3):468-469. doi: 10.1016/j.cjca.2023.11.035. Epub 2023 Dec 1.

NO ABSTRACT

PMID:38042337 | DOI:10.1016/j.cjca.2023.11.035

Physicians' attitudes towards ethical issues and end‐of‐life decision‐making for pediatric patients with unresponsive wakefulness syndrome: An international survey.

Fri, 01 Dec 2023 05:00:00 +0000

Developmental Medicine & Child Neurology; 12/01/2023
(AN 173396592); ISSN: 00121622
CINAHL Complete

Values, decision-making and empirical bioethics: a conceptual model for empirically identifying and analyzing value judgements.

Fri, 01 Dec 2023 05:00:00 +0000

Theoretical Medicine & Bioethics; 12/01/2023
(AN 173585494); ISSN: 13867415
CINAHL Complete

Conspiracy theories, clinical decision-making, and need for bioethics debate: A response to Stout

Fri, 01 Dec 2023 00:00:00 +0000

Bioethics. 2024 Feb;38(2):164-169. doi: 10.1111/bioe.13244. Epub 2023 Dec 1.

ABSTRACT

Although people who endorse conspiracy theories related to medicine often have negative attitudes toward particular health care measures and may even shun the healthcare system in general, conspiracy theories have received rather meager attention in bioethics literature. Consequently, and given that conspiracy theorizing appears rather prevalent, it has been maintained that there is significant need for bioethics debate over how to deal with conspiracy theories. While the proposals have typically focused on the effects that unwarranted conspiracy theories have in the public health context, Nathan Stout's recent argument concentrates on the impacts that such theories have at the individual level of clinical decision-making. In this article, I maintain that duly acknowledging the impacts of conspiracy theories that raise Stout's concern does not require bioethics debate over the proper response to the influence of conspiracy theories in healthcare. Having evaluated two possible objections, I conclude by briefly clarifying the purported import of the response to Stout.

PMID:38038220 | DOI:10.1111/bioe.13244

Navigating Informed Consent Requirements and Expectations in Cluster Randomized Trials: Research Ethics Board Members' and Researchers' Views

Tue, 21 Nov 2023 00:00:00 +0000

Ethics Hum Res. 2023 Nov-Dec;45(6):31-45. doi: 10.1002/eahr.500189.

ABSTRACT

Informed consent is a cornerstone of ethical human research. However, as cluster randomized trials (CRTs) are increasingly popular to evaluate health service interventions, especially as health systems aspire toward the learning health system, questions abound how research teams and research ethics boards (REBs) should navigate intertwining consent and data-use considerations. Methodological and ethical questions include who constitute the participants, whose and what types of consent are necessary, and how data from people who have not consented to participation should be managed to optimize the balance of trust in the research enterprise, respect for persons, the promotion of data integrity, and the pursuit of the public good in the research arena. In this paper, we report the findings and lessons learned from a qualitative study examining how researchers and REB members consider the ethical dimensions of when data can be collected and used in CRTs in the evolving research landscape.

PMID:37988275 | DOI:10.1002/eahr.500189

The ethics of using COVID-19 host genomic information for clinical and public health decision-making: A survey of US health professionals

Sat, 18 Nov 2023 00:00:00 +0000

HGG Adv. 2024 Jan 11;5(1):100255. doi: 10.1016/j.xhgg.2023.100255. Epub 2023 Nov 17.

ABSTRACT

Several genetic variants linked to COVID-19 have been identified by host genomics researchers. Further advances in this research will likely play a role in the clinical management and public health control of future infectious disease outbreaks. The implementation of genetic testing to identify host genomic risk factors associated with infectious diseases raises several ethical, legal, and social implications (ELSIs). As an important stakeholder group, health professionals can provide key insights into these ELSI issues. In 2021, a cross-sectional online survey was fielded to US health professionals. The survey explored how they view the value and ethical acceptability of using COVID-19 host genomic information in three main decision-making settings: (1) clinical, (2) public health, and (3) workforce. The survey also assessed participants' personal and professional experience with genomics and infectious diseases and collected key demographic data. A total of 603 participants completed the survey. A majority (84%) of participants agreed that it is ethically acceptable to use host genomics to make decisions about clinical care and 73% agreed that genetic screening has an important role to play in the public health control of COVID-19. However, more than 90% disagreed that it is ethically acceptable to use host genomics to deny resources or admission to individuals when hospital resources are scarce. Understanding stakeholder perspectives and anticipating ELSI issues will help inform policies for hospitals and public health departments to evaluate and perhaps adopt host genomic technologies in an ethically and socially responsible manner during future infectious disease outbreaks.

PMID:37978805 | PMC:PMC10746522 | DOI:10.1016/j.xhgg.2023.100255

Supported decision-making for older people living with dementia: contributions from bioethics

Thu, 16 Nov 2023 00:00:00 +0000

Cien Saude Colet. 2023 Nov;28(11):3149-3158. doi: 10.1590/1413-812320232811.00882023. Epub 2023 Mar 2.

ABSTRACT

The significant increase in the elderly population and the high incidence of chronic and degenerative diseases are a matter of concern with regard to issues inherent to promotion of autonomy and preservation of human rights and quality of life in this population group. Exercising the right to make a decision impacts various aspects of human life, such as health care, asset management, relationships, choice of housing, family care, religious activities and even daily routine activities. Supported decision-making (SDM) can be an important tool for promoting autonomy among elderly people living with dementia, as it consists of an approach based on respect for human rights, in which the aim is to establish control over the mechanisms for provision of support so that all people can exercise the right to make decisions inherent to their lives. In order to implement this more robustly in Brazil, it is fundamental to change the culture towards valuing elderly people and implementing the notion that protection involves offering mechanisms for promoting personal autonomy, which is partly achieved through encouragement of social engagement and strengthening community ties. In this regard, the notion of empowerment, based on concepts arising from Intervention Bioethics, is relevant.

PMID:37970999 | DOI:10.1590/1413-812320232811.00882023

The British Transplantation Society guidelines on ethics, law and consent in relation to deceased donors after circulatory death

Thu, 02 Nov 2023 00:00:00 +0000

Transplant Rev (Orlando). 2024 Jan;38(1):100803. doi: 10.1016/j.trre.2023.100803. Epub 2023 Oct 26.

ABSTRACT

The British Transplantation Society (BTS) 'Guideline on transplantation from deceased donors after circulatory death' has recently been updated and this manuscript summarises the relevant recommendations from chapters specifically related to law, ethics, donor consent and informing the recipient.

PMID:37919138 | DOI:10.1016/j.trre.2023.100803

New Ethical Guidance on Pediatric Decision-Making.

Wed, 01 Nov 2023 04:00:00 +0000

Medical Ethics Advisor; 11/01/2023
(AN 173241323); ISSN: 08860653
CINAHL Complete

A Systematic Approach to Ethical Decision-making for Nurses.

Wed, 01 Nov 2023 04:00:00 +0000

Colorado Nurse; 11/01/2023
The article focuses on providing a systematic approach to ethical decision-making for nurses, emphasizing the importance of understanding ethical principles and addressing potential legal issues when encountering ethical dilemmas in healthcare settings. It offers a seven-step framework, including identifying the problem, applying ethical codes, determining the nature and dimensions of the dilemma, generating potential courses of action.
(AN 173333941); ISSN: 8750846X
CINAHL Complete

Ethical decision-making: a culture influenced virtue specific model for multinational corporations.

Wed, 01 Nov 2023 04:00:00 +0000

Ethics & Behavior; 11/01/2023
Multinational corporations face a litany of challenges regarding ethical decision-making as they traverse new variables in each country they operate in. Presented here is a new approach to ethical decision-making research for multinational corporations with the inclusion of moral virtues, national culture, and a feedback mechanism. The new proposed model builds off of the existing work by Trevino's Person-Situated Interactionist Model. Hofstede's work on individual national culture characteristics is used to move the conversation forward by explaining the relationships between individual moderators in Trevino's model and the effect of national culture on them. The new proposed model recommends the inclusion of moral virtues, with honesty and integrity as examples, as individual moderators in the decision-making process based on previous work. It contributes to the literature by introducing moral virtues into traditional ethical decision-making process models and introduces a new variable with a feedback mechanism for future learning. The paper concludes with recommendations for the future direction of research for ethical decision-making models for multinational organizations.
(AN 173321388); ISSN: 10508422
CINAHL Complete

The impact of nursing students' biomedical and artificial intelligence ethical awareness, ethical values, and professional self-concept on their ethical decision-making confidence.

Wed, 01 Nov 2023 04:00:00 +0000

Journal of Korean Academic Society of Nursing Education (JKASNE); 11/01/2023
(AN 174444955); ISSN: 12259578
CINAHL Complete