Abstract:
OBJECTIVE:The purpose of this article is to investigate the need for ethics support in Dutch healthcare institutions in order to understand why ethics support is often not used in practice and which factors are relevant in this context. METHODS:This study had a mixed methods design integrating quantitative and qualitative research methods. Two survey questionnaires, two focus groups and 17 interviews were conducted among board members and ethics support staff in Dutch healthcare institutions. FINDINGS:Most respondents see a need for ethics support. This need is related to the complexity of contemporary healthcare, the contribution of ethics support to the core business of the organisation and to the surplus value of paying structural attention to ethical issues. The need for ethics support is, however, not unconditional. Reasons for a lacking need include: aversion of innovations, negative associations with the notion of ethics support service, and organisational factors like resources and setting. CONCLUSION:There is a conditioned need for ethics support in Dutch healthcare institutions. The promotion of ethics support in healthcare can be fostered by focusing on formats which fit the needs of (practitioners in) healthcare institutions. The emphasis should be on creating a (culture of) dialogue about the complex situations which emerge daily in contemporary healthcare practice.
journal_name
J Med Ethicsjournal_title
Journal of medical ethicsauthors
Dauwerse L,Abma T,Molewijk B,Widdershoven Gdoi
10.1136/jme.2010.040626subject
Has Abstractpub_date
2011-08-01 00:00:00pages
456-60issue
8eissn
0306-6800issn
1473-4257pii
jme.2010.040626journal_volume
37pub_type
杂志文章,多中心研究abstract::Two protechnology arguments, the "hopeful principle" and the "automatic escalator", often used in bioethics, are identified and critically analysed in this paper. It is shown that the hopeful principle is closely related to the problematic precautionary principle, and the automatic escalator argument has close affinit...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.2006.016477
更新日期:2007-01-01 00:00:00
abstract::In this issue of the journal Mark Brown has offered a new argument against my potential future of value theory. I argue that even though the premises of this new argument are far more defensible than the premises of his old argument, the new argument does not show that the potential future of value theory of the wrong...
journal_title:Journal of medical ethics
pub_type: 评论,杂志文章
doi:10.1136/jme.28.3.198
更新日期:2002-06-01 00:00:00
abstract::This opinion piece aims to situate the placebo effect within the field of psychiatric treatment. To accomplish this, the placebo is explored at the centre of an often heated debate between three discrete perspectives: the clinical trial researcher, the placebo researcher and the clinician. Each occupational perspectiv...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2013-101410
更新日期:2014-06-01 00:00:00
abstract::In 'Abortion and deprivation: a reply to Marquis', Anna Christensen contends that Don Marquis' influential 'future like ours' argument for the immorality of abortion faces a significant challenge from the Epicurean claim that human beings cannot be harmed by their death. If deprivation requires a subject, then abortio...
journal_title:Journal of medical ethics
pub_type: 评论,杂志文章
doi:10.1136/medethics-2018-105267
更新日期:2019-07-01 00:00:00
abstract::In popular lay discourse, objections to human biological enhancement technologies are sometimes expressed in terms of the charge that they are unnatural. This paper critiques the literal claim that seems to be presented here, namely that such technologies are in some ordinary sense 'unnatural' and that it follows from...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2018-104991
更新日期:2019-02-01 00:00:00
abstract::Downie comments on Sieghart's article, "Professions as the conscience of society" (Journal of Medical Ethics 1985 Sep; 11(3): 117-122). He charges that Sieghart is blurring empirical, conceptual, and moral claims when he contends that the professional relationship is unique in that "altruism is paramount and self-int...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.12.2.64
更新日期:1986-06-01 00:00:00
abstract::With the recent Clinical Trials Directive, a degree of harmonisation into research ethics committees (RECs) across Europe, including the time taken to assess a trial proposal and the kinds of issues a committee should take into account, has been introduced by the European Union (EU). How four different member states-H...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.2005.013888
更新日期:2006-08-01 00:00:00
abstract::Competent patients who refuse life saving medical treatment present a dilemma for healthcare professionals. On one hand, respect for autonomy and liberty demand that physicians respect a patient's decision to refuse treatment. However, it is often apparent that such patients are not fully competent. They may not adequ...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.2002.000877
更新日期:2005-01-01 00:00:00
abstract::Determining whether a research risk meets or exceeds a regulatory standard of risk acceptability is difficult. Recently a framework called the systematic evaluation of research risks (SERR) has been proposed as a method of comparing research risks with predetermined standards of acceptability. SERR purports to offer a...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2011-100194
更新日期:2012-07-01 00:00:00
abstract::Many children in the USA are prescribed psychotropic drugs that have not been fully investigated in paediatric clinical trials. The common practice of prescribing psychotropic drugs off-label poses unknown and potentially serious short- and long-term consequences for these children. This paper briefly reviews the fact...
journal_title:Journal of medical ethics
pub_type: 杂志文章,评审
doi:10.1136/medethics-2011-100003
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:Medical tourism involves patients travelling internationally to receive medical services. This practice raises a range of ethical issues, including potential harms to the patient's home and destination country and risks to the patient's own health. Medical tourists often engage the services of a facilitator ...
journal_title:Journal of medical ethics
pub_type: 杂志文章,多中心研究
doi:10.1136/jme.2011.042374
更新日期:2011-09-01 00:00:00
abstract::As a science and practice transcending metaphysical and ethical disagreements, 'secular' medicine should not exist. 'Secularity' should be understood in an Augustinian sense, not a secularist one: not as a space that is universally rational because it is religion-free, but as a forum for the negotiation of rival reaso...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2013-101776
更新日期:2015-03-01 00:00:00
abstract::In this paper we identify and evaluate arguments for and against offering assisted reproductive technologies (ART), specifically IVF, to HIV discordant couples (male partner HIV positive, female partner HIV negative). The idea of offering ART to HIV discordant couples generates concerns about safety and public health ...
journal_title:Journal of medical ethics
pub_type: 杂志文章,评审
doi:10.1136/jme.29.6.325
更新日期:2003-12-01 00:00:00
abstract::Physician-written "do not resuscitate" DNR orders elicit negative reactions from stakeholders that may decrease appropriate end-of-life care. The semantic significance of the phrase has led to a proposed replacement of DNR with "allow natural death" (AND). Prior to this investigation, no scientific papers address the ...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.2006.018317
更新日期:2008-01-01 00:00:00
abstract::Recently, there has been a lot of enthusiasm for mindfulness practice and its use in healthcare, businesses and schools. An increasing number of studies give us ground for cautious optimism about the potential of mindfulness-based interventions (MBIs) to improve people's lives across a number of dimensions. This paper...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2015-102942
更新日期:2016-07-01 00:00:00
abstract:OBJECTIVES:In treating critically ill neonates, situations occasionally arise in which aggressive medical treatment prolongs the inevitable death rather than prolonging life. Decisions as to limitation of neonatal medical intervention remain controversial and the primary responsibility of the generally unprepared famil...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.23.3.164
更新日期:1997-06-01 00:00:00
abstract::The Groningen protocol allows for the euthanasia of severely ill newborns with a hopeless prognosis and unbearable suffering. We understand the impetus for such a protocol but have moral and ethical concerns with it. Advocates for euthanasia in adults have relied on the concept of human autonomy, which is lacking in t...
journal_title:Journal of medical ethics
pub_type: 评论,杂志文章,评审
doi:10.1136/jme.2005.012476
更新日期:2006-03-01 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::Literary accounts of traumatic events can be more informative and insightful than personal testimonials. In particular, reference to works of literature can give us a more vivid sense of what it is like to receive a devastating diagnosis. In turn this can lead us to question some common assumptions about the nature of...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.24.2.123
更新日期:1998-04-01 00:00:00
abstract::Several religious traditions are widely believed to advocate the use of life-sustaining treatment in all circumstances. Hence, many believe that these faiths would require the use of a feeding tube in patients with advanced dementia who have lost interest in or the capacity to swallow food. This article explores wheth...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.27.1.12
更新日期:2001-02-01 00:00:00
abstract::The complex of cultural, political and societal affiliations, both in a historic and a contemporary perspective, is expressed by a special term in the Nordic languages, 'faellesskab', often with the addition of 'folkelig', as 'folkeligt faellesskab', where 'folkelig' means of the people. No corresponding term exists i...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.17.1.41
更新日期:1991-03-01 00:00:00
abstract:BACKGROUND:Wish-fulfilling medicine appears to be on the rise. It can be defined as 'doctors and other health professionals using medical means (medical technology, drugs, and so on) in a medical setting to fulfil the explicitly stated, prima facie non-medical wish of a patient'. Some instances of wish fulfilling medic...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2013-101480
更新日期:2014-12-01 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:OBJECTIVES:This study aimed to determine the ability to successfully contact past paediatric patients and their families to request participation in research, to assess familial views on the use of previously collected archival clinical samples for research purposes, and to highlight the ethical and practical issues in...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2015-103141
更新日期:2016-07-01 00:00:00
abstract:OBJECTIVES:To study the attitudes of both medical and non-medical students towards the do-not-resuscitate (DNR) decision in a university in Hong Kong, and the factors affecting their attitudes. METHODS:A questionnaire-based survey conducted in the campus of a university in Hong Kong. Preferences and priorities of part...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.2005.014423
更新日期:2007-05-01 00:00:00
abstract::Transcranial direct current stimulation (tDCS), a simple means of brain stimulation, possesses a trifecta of appealing features: it is relatively safe, relatively inexpensive and relatively effective. It is also relatively easy to obtain a device and the do-it-yourself (DIY) community has become galvanised by reports ...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/medethics-2013-101458
更新日期:2015-05-01 00:00:00
abstract::In this commentary on 'Why participating in (certain) scientific research is a moral duty', I take issue with a number of Stjernschantz Forsberg et al's claims. Though abiding by the terms of a contract might be obligatory, this won't show that those terms themselves indicate a duty--even allowing that there's a contr...
journal_title:Journal of medical ethics
pub_type: 评论,杂志文章
doi:10.1136/medethics-2013-101370
更新日期:2014-05-01 00:00:00
abstract::This paper argues that the HFEA's recent report on sex selection abdicates its responsibility to give its own authentic advice on the matters within its remit, that it accepts arguments and conclusions that are implausible on the face of it and where they depend on empirical claims, produces no empirical evidence what...
journal_title:Journal of medical ethics
pub_type: 杂志文章
doi:10.1136/jme.2003.007526
更新日期:2005-05-01 00:00:00
abstract::According to the two-tragedies argument proponents of pro-life can justifiably prioritize efforts to prevent abortion rather than miscarriages due to the fact that abortions in contrast to miscarriages involves usually the act of killing. William Simkulet has recently argued against this argument claiming that it fail...
journal_title:Journal of medical ethics
pub_type: 评论,杂志文章
doi:10.1136/medethics-2019-105489
更新日期:2019-06-01 00:00:00
abstract::In his paper "Scientific research is a moral duty", John Harris argues that individuals have a moral duty to participate in biomedical research by volunteering as research subjects. He supports his claim with reference to what he calls the principle of beneficence as embodied in the "rule of rescue" (the moral obligat...
journal_title:Journal of medical ethics
pub_type: 评论,杂志文章
doi:10.1136/jme.2006.017384
更新日期:2007-07-01 00:00:00