Abstract:
:The concept of evidence-based medicine (EBM) has been invented by physicians mostly from English Canada, mostly from McMaster University, Ontario, Canada. The term EBM first appeared in the biomedical literature in 1991 in an article written by a prominent member of this group-Gordon Guyatt from McMaster University. The inventors of EBM have also created the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) working group, which is a prominent international organisation whose main purpose is to develop evidence-based clinical practice guidelines (CPGs). CPGs that are based on the GRADE approach are becoming increasingly adopted worldwide, in particular by many professional or governmental organisations. This group of thinkers being thus identified, we have retrieved and read many of their publications in order to try and understand how they intend to incorporate bioethical values into their concept. The author of this little essay did also spend a few years on the internet as an active member of the GRADE group discussion list. The observations thus gathered suggest that although some of the inventors of EBM, at least Gordon Guyatt, wish to incorporate core principles of biomedical ethics into their concept (ie, non-malevolence, beneficence and maybe to a lesser extent respect for autonomy, and justice), some clarifications are still necessary in order to better understand how they intend to more explicitly incorporate bioethical values into their concept and, perhaps more importantly, into evidence-based CPGs.
journal_name
J Med Ethicsjournal_title
Journal of medical ethicsauthors
Watine Jdoi
10.1136/jme.2010.039735subject
Has Abstractpub_date
2011-03-01 00:00:00pages
184-6issue
3eissn
0306-6800issn
1473-4257pii
jme.2010.039735journal_volume
37pub_type
杂志文章abstract:OBJECTIVE:To explore the experiences of people with a "terminal illness", focusing on the patients' perspective of euthanasia and assisted suicide. METHOD:A qualitative study using narrative interviews was conducted throughout the UK. The views of the 18 people who discussed euthanasia and assisted suicide were explor...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.2006.015883
更新日期:2006-12-01 00:00:00
abstract::As the law around surgical consent continues to evolve, surgeons and those in training risk being caught red-faced and defenceless. Despite repeated concerns regarding surgical consent being raised by the General Medical Council of the UK, how much is changing on the National Health Service shop floor? This report inv...
journal_title:Journal of medical ethics
pub_type: 杂志文章,评审
doi:10.1136/medethics-2013-101931
更新日期:2015-02-01 00:00:00
abstract::The concept of Hisba in Muslim law has been used by members of certain Islamic groups to impose, through the courts, limitations on freedom of expression. In so doing they sought to circumvent the right of parliament to legislate on matters of personal freedom. This device is now restricted by the Egyptian authorities...
journal_title:Journal of medical ethics
pub_type: 评论,杂志文章
doi:10.1136/jme.28.4.223
更新日期:2002-08-01 00:00:00
abstract::This paper relates two experiences of teaching medical ethics, the first to a small group of clinical medical students, the second to a larger group of GP trainees. :Boyd, a theologian who is Scottish Director of the Institute of Medical Ethics, comments on a day he spent teaching two ethics sessions, one to a group ...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.13.3.132
更新日期:1987-09-01 00:00:00
abstract::Dolores Dooley Clarke describes how the course in medical ethics at University College, Cork is structured, how it has changed and how it is likely to change as time goes on. Originally, the students seemed to view it as an intrusion 'to be tolerated' in their programme of 'strictly medical' studies. However, having m...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.4.1.36
更新日期:1978-03-01 00:00:00
abstract:OBJECTIVE:Informed consent and protection of patient confidentiality are central to the conduction of clinical research. Consent for chart review and contact (CCRC) allows a patient chart to be screened for research by persons outside the direct circle-of-care and for the patient to be contacted regarding potential stu...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2013-101765
更新日期:2015-05-01 00:00:00
abstract::"Terminal sedation" refers to the use of sedation as palliation in dying patients with a terminal diagnosis. Although terminal sedation has received widespread legal and ethical justification, the practice remains ethically contentious, particularly as some hold that it foreseeably hastens death. It has been proposed ...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.2006.019224
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVES:To analyse the decision making for end of life care for patients with cancer at a teaching hospital in Japan at two periods 10 years apart. DESIGN AND SETTING:Retrospective study conducted in a 550 bed community teaching hospital in Okinawa, Japan. PATIENTS:There were 124 terminally ill cancer patients (45...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.2003.000125
更新日期:2004-06-01 00:00:00
abstract::I explain the notion of contributory injustice, a kind of epistemic injustice, and argue that it occurs within psychiatric services, affecting (at least) those who hear voices. I argue that individual effort on the part of clinicians to avoid perpetrating this injustice is an insufficient response to the problem; miti...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2018-104761
更新日期:2019-02-01 00:00:00
abstract::With so much attention being paid to the development and refinement of appropriate criteria and tests for death, little attention has been given to the broader conceptual issues having to do with its definition or with the relation of a definition to its criterion. The task of selecting the correct criterion is, howev...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.21.5.270
更新日期:1995-10-01 00:00:00
abstract::Giubilini and Minerva argue that the permissibility of abortion entails the permissibility of infanticide. Proponents of what we refer to as the Birth Strategy claim that there is a morally significant difference brought about at birth that accounts for our strong intuition that killing newborns is morally impermissib...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2020-106781
更新日期:2020-10-26 00:00:00
abstract::It is unclear whether or not grant winning should count towards authorship credit in the sciences. In this paper, I argue that under certain circumstances grant winning can count for credit as an author on subsequent works. It is a mistake to think that grant winning is always irrelevant to the correct attribution of ...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2012-101315
更新日期:2014-10-01 00:00:00
abstract::Public and healthcare professionals differ in their attitudes towards euthanasia and physician-assisted suicide (PAS), the legal status of which is currently in the spotlight in the UK. In addition to medical training and experience, religiosity, locus of control and patient characteristics (eg, patient age, pain leve...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2012-100729
更新日期:2013-11-01 00:00:00
abstract::Therapeutic privilege (TP) is a defence that may be available to doctors who fail to disclose to the patient relevant information when seeking informed consent for treatment if they have a reasonable belief that providing that information would likely cause the patient concerned serious physical or mental harm. In a l...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2019-105792
更新日期:2021-01-01 00:00:00
abstract::Moral principles or the rules of conduct are based in the society. If the purpose of ethics in research is to take into consideration the needs and the rights of the experimental subject, his social milieu must then largely determine the ethical considerations of a projected study. The inability to comprehend such rig...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.6.2.61
更新日期:1980-06-01 00:00:00
abstract:OBJECTIVE:The President's Council on Bioethics in 2008 reaffirmed the necessity of the dead donor rule and the legitimacy of the current criteria for diagnosing both neurological and cardiac death. In spite of this report,many have continued to express concerns about the ethics of donation after circulatory death, the ...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2013-101333
更新日期:2014-07-01 00:00:00
abstract::In his critical comment on our paper in this journal, Shaw argues that 'false assumptions' which we have criticised are in fact correct ('Neuroenhancers, addiction and research ethics'). He suggests that the risk of addiction to neuroenhancers may not be relevant, and that safety and research in regard to neuroenhance...
journal_title:Journal of medical ethics
pub_type: 评论,杂志文章
doi:10.1136/medethics-2013-101317
更新日期:2014-04-01 00:00:00
abstract::Many patients believe that cardiopulmonary resuscitation (CPR) is more likely to be successful than it really is in clinical practice. Even when working with accurate information, some nevertheless remain resolute in demanding maximal treatment. They maintain that even if survival after cardiac arrest with CPR is extr...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2019-105558
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVES:To study the ethical reasoning of nurses and physicians, and to assess whether or not modified focus groups are a valuable tool for this purpose. DESIGN:Discussion of cases in modified focus groups, each consisting of three physicians and three nurses. The discussion was taped and analysed by content analys...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.22.3.168
更新日期:1996-06-01 00:00:00
abstract:OBJECTIVES:To evaluate the UK undergraduate medical ethics curricula against the Institute of Medical Ethics (IME) recommendations; to identify barriers to teaching and assessment of medical ethics and to evaluate perceptions of ethics faculties on the preparation of tomorrow's doctors for clinical practice. DESIGN:Qu...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2015-103189
更新日期:2017-09-01 00:00:00
abstract::I sketch a libertarian argument for the right to test in the context of 'direct to consumer' (DTC) genetic testing. A libertarian right to genetic tests, as defined here, relies on the idea of a moral right to self-ownership. I show how a libertarian right to test can be inferred from this general libertarian premise,...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2015-102827
更新日期:2016-09-01 00:00:00
abstract::In a recent article, Udo Schuklenk and Suzanne van de Vathorst argued in favour of a legal option of physician-assisted death for patients with 'treatment-resistant' depression. In this commentary, I contend that their argument neglects the important consideration of the professional integrity of physicians. In light ...
journal_title:Journal of medical ethics
pub_type: 评论,杂志文章
doi:10.1136/medethics-2015-103060
更新日期:2015-11-01 00:00:00
abstract::In a recent article in this journal, Anna Christensen raises an 'Epicurean challenge' to Don Marquis' much-discussed argument for the immorality of abortion. According to Marquis' argument, abortion is pro tanto morally wrong because it deprives the fetus of 'a future like ours'. Drawing on the Epicurean idea that dea...
journal_title:Journal of medical ethics
pub_type: 评论,杂志文章
doi:10.1136/medethics-2019-105771
更新日期:2020-04-01 00:00:00
abstract::The patient, a 59-year-old man, was referred to a psychiatric hospital with what appeared initially to be the signs and symptoms of mental disorder. In hospital a lesion of the brain was diagnosed and surgery was proposed to relieve the condition. The patient, however, during this and subsequent admissions to hospital...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.1.3.146
更新日期:1975-09-01 00:00:00
abstract::In contemporary medical ethics health is rarely acknowledged to be an ethical obligation. This oversight is due to the preoccupation of most bioethicists with a rationalist, contract model for ethics in which moral obligation is limited to truth-telling and promise-keeping. Such an ethics is poorly suited to medicine ...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.10.3.138
更新日期:1984-09-01 00:00:00
abstract::The aim of this study was to determine the opinions of private medical practitioners in Bloemfontein, South Africa, regarding euthanasia of terminally ill patients. This descriptive study was performed amongst a simple random sample of 100 of 230 private medical practitioners in Bloemfontein. Information was obtained ...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.2008.027417
更新日期:2009-03-01 00:00:00
abstract::Simon Rippon has recently argued against kidney markets on the grounds that introducing the option to vend will result in many people, especially the poor, being subject to harmful pressure to vend. Though compelling, Rippon's argument fails. What he takes to be a single phenomenon-social and legal pressure to vend-is...
journal_title:Journal of medical ethics
pub_type: 评论,杂志文章
doi:10.1136/medethics-2014-102390
更新日期:2015-06-01 00:00:00
abstract:OBJECTIVES:To study the attitudes of health care staff in four postcommunist countries towards taking gifts from their clients--and their confessed experience of actually taking such gifts. DESIGN:Survey questionnaire administered to officials including health care staff, supplemented by focus-group discussions with t...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.26.5.305
更新日期:2000-10-01 00:00:00
abstract::We are printing in its entirety the discussion document which sets out a code of professional conduct for nurses published by the Royal College of Nursing in November 1976 together with commentaries by the Assistant Secretary of the British Medical Association, a professor of nursing studies, student nurses and a lawy...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.3.3.115
更新日期:1977-09-01 00:00:00
abstract::The most publicly justifiable application of human cloning, if there is one at all, is to provide self-compatible cells or tissues for medical use, especially transplantation. Some have argued that this raises no new ethical issues above those raised by any form of embryo experimentation. I argue that this research is...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.25.2.87
更新日期:1999-04-01 00:00:00