Abstract:
BACKGROUND:How should clinical ethics support services such as clinical ethics committees (CECs) be implemented and evaluated? We argue that both the CEC itself and the implementation of the CEC should be considered as 'complex interventions'. MAIN TEXT:We present a research project involving the implementation of CECs in community care in four Norwegian municipalities. We show that when both the CEC and its implementation are considered as complex interventions, important consequences follow - both for implementation and the study thereof. Emphasizing four such sets of consequences, we argue, first, that the complexity of the intervention necessitates small-scale testing before larger-scale implementation and testing is attempted; second, that it is necessary to theorize the intervention in sufficient depth; third, that the identification of casual connections charted in so-called logic models allows the identification of factors that are vital for the intervention to succeed and which must therefore be studied; fourth, that an important part of a feasibility study must be to identify and chart as many as possible of the causally important contextual factors. CONCLUSION:The conceptualization of the implementation of a CEC as a complex intervention shapes the intervention and the way evaluation research should be performed, in several significant ways. We recommend that researchers consider whether a complex intervention approach is called for when studying CESS implementation and impact.
journal_name
BMC Med Ethicsjournal_title
BMC medical ethicsauthors
Magelssen M,Karlsen H,Pedersen R,Thoresen Ldoi
10.1186/s12910-020-00522-1subject
Has Abstractpub_date
2020-09-01 00:00:00pages
82issue
1issn
1472-6939pii
10.1186/s12910-020-00522-1journal_volume
21pub_type
杂志文章abstract:BACKGROUND:France has long been a country of immigration and in some respects may be seen to have a generous policy with respect to asylum seekers and access to health care for migrants. The French state notably provides healthcare access for undocumented migrants, through state medical aid and since 1998 has had a hum...
journal_title:BMC medical ethics
pub_type: 杂志文章
doi:10.1186/s12910-020-00500-7
更新日期:2020-07-13 00:00:00
abstract:BACKGROUND:The increased use of human biological material for cell-based research and clinical interventions poses risks to the privacy of patients and donors, including the possibility of re-identification of individuals from anonymized cell lines and associated genetic data. These risks will increase as technologies ...
journal_title:BMC medical ethics
pub_type: 杂志文章
doi:10.1186/1472-6939-15-7
更新日期:2014-02-03 00:00:00
abstract:BACKGROUND:The generation of evidence is integral to the work of public health and health service providers. Traditionally, ethics has been addressed differently in research projects, compared with other forms of evidence generation, such as quality improvement, program evaluation, and surveillance, with review of non-...
journal_title:BMC medical ethics
pub_type: 杂志文章
doi:10.1186/1472-6939-15-61
更新日期:2014-08-08 00:00:00
abstract:BACKGROUND:In studies publishing identifying personal information, obtaining consent is regarded as necessary, as it is impossible to ensure complete anonymity. However, current journal practices around specific points to consider when obtaining consent, the contents of consent forms and how consent forms are managed h...
journal_title:BMC medical ethics
pub_type: 杂志文章
doi:10.1186/1472-6939-14-47
更新日期:2013-11-25 00:00:00
abstract:BACKGROUND:Financial relationships between physicians and industry are extensive and public reporting of industry payments to physicians is now occurring. Our objectives were to describe physician recipients of large total payments from these seven companies, and to examine discrepancies between these payments and conf...
journal_title:BMC medical ethics
pub_type: 杂志文章
doi:10.1186/1472-6939-13-24
更新日期:2012-09-26 00:00:00
abstract:BACKGROUND:The individual informed consent model remains critical to the ethical conduct and regulation of research involving human beings. Parental informed consent process in a rural setting of northern Ghana was studied to describe comprehension and retention among parents as part of the evaluation of the existing i...
journal_title:BMC medical ethics
pub_type: 杂志文章
doi:10.1186/1472-6939-9-12
更新日期:2008-06-19 00:00:00
abstract:BACKGROUND:When a new intervention or drug is developed, this has to pass through various phases of clinical testing before it achieves market approval, which can take many years. This raises an issue for drugs which could benefit terminally ill patients. These patients might set their hopes on the experimental drug bu...
journal_title:BMC medical ethics
pub_type: 杂志文章
doi:10.1186/s12910-016-0145-x
更新日期:2016-10-18 00:00:00
abstract:BACKGROUND:The use of empirical research methods in bioethics has been increasing in the last decades. It has resulted in discussions about the 'empirical turn of bioethics' and raised questions related to the value of empirical work for this field, methodological questions about its quality and rigor, and how this int...
journal_title:BMC medical ethics
pub_type: 杂志文章,多中心研究
doi:10.1186/s12910-017-0239-0
更新日期:2017-12-22 00:00:00
abstract:BACKGROUND:Family members do not have an official position in the practice of euthanasia and physician assisted suicide (EAS) in the Netherlands according to statutory regulations and related guidelines. However, recent empirical findings on the influence of family members on EAS decision-making raise practical and eth...
journal_title:BMC medical ethics
pub_type: 杂志文章
doi:10.1186/s12910-019-0361-2
更新日期:2019-04-05 00:00:00
abstract:BACKGROUND:The study examined the knowledge and attitudes to personal genomics testing for complex diseases among Nigerians and identified how the knowledge and attitudes vary with gender, age, religion, education and related factors. METHODS:Data were collected using qualitative method in 2 districts of the Federal C...
journal_title:BMC medical ethics
pub_type: 杂志文章
doi:10.1186/1472-6939-15-34
更新日期:2014-04-27 00:00:00
abstract:BACKGROUND:Donepezil, an acetylcholinesterase inhibitor used in the treatment of Alzheimer's disease, has been widely cited in media and bioethics literature on cognitive enhancement (CE) as having the potential to improve the cognitive ability of healthy individuals. In both literatures, this claim has been repeatedly...
journal_title:BMC medical ethics
pub_type: 杂志文章
doi:10.1186/1472-6939-15-37
更新日期:2014-05-12 00:00:00
abstract:BACKGROUND:Various forms of Clinical Ethics Support (CES) have been developed in health care organizations. Over the past years, increasing attention has been paid to the question of how to foster the quality of ethics support. In the Netherlands, a CES quality assessment project based on a responsive evaluation design...
journal_title:BMC medical ethics
pub_type: 杂志文章
doi:10.1186/s12910-019-0418-2
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:This paper explores ethical concerns arising in healthcare integration. We argue that integration is necessary imperative for meeting contemporary and future healthcare challenges, a far stronger evidence base for the conditions of its effectiveness is required. In particular, given the increasing emphasis a...
journal_title:BMC medical ethics
pub_type: 杂志文章
doi:10.1186/s12910-019-0386-6
更新日期:2019-07-03 00:00:00
abstract:BACKGROUND:Ethics committees typically apply the common principles of autonomy, nonmaleficence, beneficence and justice to research proposals but with variable weighting and interpretation. This paper reports a comparison of ethical requirements in an international cross-cultural study and discusses their implications....
journal_title:BMC medical ethics
pub_type: 杂志文章
doi:10.1186/1472-6939-3-2
更新日期:2002-04-19 00:00:00
abstract:BACKGROUND:Since 2010, the European Journal of Anaesthesiology has required the reporting of five items concerning ethical approval in articles describing human research: ethics committee's name and address, chairperson's name, study's protocol number and approval date. We aimed to assess whether this requirement has h...
journal_title:BMC medical ethics
pub_type: 杂志文章
doi:10.1186/s12910-018-0289-y
更新日期:2018-06-08 00:00:00
abstract:BACKGROUND:Health checks or health screenings identify (risk factors for) disease in people without a specific medical indication. So far, the perspective of (potential) health check users has remained underexposed in discussions about the ethics and regulation of health checks. METHODS:In 2017, we conducted a qualita...
journal_title:BMC medical ethics
pub_type: 杂志文章
doi:10.1186/s12910-018-0301-6
更新日期:2018-06-22 00:00:00
abstract:BACKGROUND:Despite the growing recognition for the need to improve the health of prisoners in Canada and the need for health research, there has been little discussion of the ethical issues with regards to health research with prisoners in Canada. The purpose of this paper is to encourage a national conversation about ...
journal_title:BMC medical ethics
pub_type: 杂志文章
doi:10.1186/s12910-017-0189-6
更新日期:2017-04-27 00:00:00
abstract:BACKGROUND:Clinical Ethics Committees (CECs) are well established at healthcare institutions in resource-rich countries. However, there is limited information on established CECs in resource poor countries, especially in Africa. This study aimed to establish baseline data regarding existing formal CECs in Africa to rai...
journal_title:BMC medical ethics
pub_type: 杂志文章
doi:10.1186/s12910-020-00559-2
更新日期:2020-11-18 00:00:00
abstract:BACKGROUND:Expectations of receiving personal health information as a fringe benefit of biospecimen donation-termed diagnostic misconception-are increasingly documented. We developed an instrument measuring conflation of observational biospecimen-based research and clinical care for use with Latino communities, who may...
journal_title:BMC medical ethics
pub_type: 杂志文章
doi:10.1186/s12910-015-0041-9
更新日期:2015-07-17 00:00:00
abstract:BACKGROUND:HIV prevention research in resource-limited countries is associated with a variety of ethical dilemmas. Key amongst these is the question of what constitutes an appropriate standard of health care (SoC) for participants in HIV prevention trials. This paper describes a community-focused approach to develop a ...
journal_title:BMC medical ethics
pub_type: 杂志文章
doi:10.1186/1472-6939-10-17
更新日期:2009-10-09 00:00:00
abstract:BACKGROUND:Family members are often required to act as substitute decision-makers when health care or research participation decisions must be made for an incapacitated relative. Yet most families are unable to accurately predict older adult preferences regarding future health care and willingness to engage in research...
journal_title:BMC medical ethics
pub_type: 杂志文章,随机对照试验
doi:10.1186/1472-6939-13-1
更新日期:2012-01-05 00:00:00
abstract:BACKGROUND:Few studies have examined factors associated with willingness of people living with HIV (PLHIV) to participate in HIV treatment clinical trials in Sub-Saharan Africa. We assessed the factors associated with participation of PLHIV in HIV treatment clinical trials research at a large urban clinical and researc...
journal_title:BMC medical ethics
pub_type: 杂志文章
doi:10.1186/s12910-020-00516-z
更新日期:2020-08-24 00:00:00
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journal_title:BMC medical ethics
pub_type: 杂志文章,评审
doi:10.1186/s12910-016-0153-x
更新日期:2016-11-10 00:00:00
abstract:BACKGROUND:Studies on informed consent to medical research conducted in low or middle-income settings have increased, including empirical investigations of consent to genetic research. We investigated voluntary participation and comprehension of informed consent among women involved in a genetic epidemiological study o...
journal_title:BMC medical ethics
pub_type: 杂志文章
doi:10.1186/1472-6939-15-38
更新日期:2014-05-13 00:00:00
abstract:BACKGROUND:Over the past 25 years, there has been growing recognition of the importance of studying the Ethical, Legal and Social Implications (ELSI) of genetic and genomic research. A large investment into ELSI research from the National Institutes of Health (NIH) Human Genomic Project budget in 1990 stimulated the gr...
journal_title:BMC medical ethics
pub_type: 杂志文章
doi:10.1186/s12910-016-0121-5
更新日期:2016-07-08 00:00:00
abstract:BACKGROUND:Although informed consent is an integral part of clinical practice, its current doctrine remains mostly a matter of law and mainstream ethics rather than empirical research. There are scarce empirical data on patients' perceived purpose of informed consent, which may include administrative routine/courtesy g...
journal_title:BMC medical ethics
pub_type: 杂志文章
doi:10.1186/1472-6939-15-2
更新日期:2014-01-10 00:00:00
abstract:BACKGROUND:Appropriate information and consent has been one of the most intensely discussed topics within the context of biobank research. In parallel to the normative debate, many socio-empirical studies have been conducted to gather experiences, preferences and views of patients, healthy research participants and fur...
journal_title:BMC medical ethics
pub_type: 杂志文章,评审
doi:10.1186/s12910-015-0053-5
更新日期:2015-09-09 00:00:00
abstract:BACKGROUND:The ethical principle of justice demands that resources be distributed equally and based on evidence. Guidelines regarding forgoing of CPR are unavailable and there is large variance in the reported rates of attempted CPR in in-hospital cardiac arrest. The main objective of this work was to study whether loc...
journal_title:BMC medical ethics
pub_type: 杂志文章
doi:10.1186/s12910-019-0439-x
更新日期:2019-12-26 00:00:00
abstract:BACKGROUND:The widespread sharing of biologicaConcluding Comments: Teaching Responsible Datal and biomedical data is recognised as a key element in facilitating translation of scientific discoveries into novel clinical applications and services. At the same time, twenty-first century states are increasingly concerned t...
journal_title:BMC medical ethics
pub_type: 杂志文章
doi:10.1186/s12910-016-0112-6
更新日期:2016-05-17 00:00:00
abstract:BACKGROUND:Few empirical studies have been found that explore ethical challenges among persons in high public positions that are responsible for elder care. The aim of this paper was to illuminate the meaning of being in ethically difficult situations related to elder care as experienced by high level decision-makers. ...
journal_title:BMC medical ethics
pub_type: 杂志文章
doi:10.1186/1472-6939-8-3
更新日期:2007-04-10 00:00:00