Clinical Ethics Committees in Africa: lost in the shadow of RECs/IRBs?

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 raise awareness of and to encourage the establishment of CECs or Clinical Ethics Consultation Services (CESs) on the continent. METHODS:A descriptive study was undertaken using an online questionnaire via SunSurveys to survey healthcare professionals and bioethicists in Africa. Data were subjected to descriptive analysis and Fischer's exact test was applied to determine associations. Texts from the open-ended questions were thematically analysed. RESULTS:In total 109 participants from 37 African countries completed the survey in December 2019. A significant association was found between participants' bioethics qualification or training and involvement in clinical ethics (p = 0.005). All participants were familiar with Research Ethics Committees (RECs), and initially conflated RECs with CECs. When CECs were explained in detail, approximately 85.3% reported that they had no formal CECs in their institutions. The constraints to developing CECs included lack of training, limited resources, and lack of awareness of CECs. However, the majority of participants (81.7%) were interested in establishing CECs. Participants listed assistance required in establishing CECs including funding, resources, capacity building and collaboration with other known CECs. The results do not reflect CECs established since the onset of COVID-19 in Africa. CONCLUSIONS:This study provides a first look into CECs in Africa and found very few formal CECs on the continent indicating an urgent need for the establishment of CECs or CESs in Africa. While the majority of healthcare professionals and bioethicists are aware of ethical dilemmas in healthcare, the concept of formal CECs is foreign. This study served to raise awareness of CECs. Research ethics and RECs overshadow CECs in Africa because international funders from the global north support capacity development in research ethics and establish RECs to approve the research they fund in Africa. Raising awareness via educational opportunities, research and conferences about CECs and their role in improving the quality of health care in Africa is sorely needed.

journal_name

BMC Med Ethics

journal_title

BMC medical ethics

authors

Moodley K,Kabanda SM,Soldaat L,Kleinsmidt A,Obasa AE,Kling S

doi

10.1186/s12910-020-00559-2

subject

Has Abstract

pub_date

2020-11-18 00:00:00

pages

115

issue

1

issn

1472-6939

pii

10.1186/s12910-020-00559-2

journal_volume

21

pub_type

杂志文章
  • Lessons learned from implementing a responsive quality assessment of clinical ethics support.

    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

    authors: Van Baarle EM,Potma MC,van Hoek MEC,Hartman LA,Molewijk BAC,van Gurp JLP

    更新日期:2019-11-01 00:00:00

  • Microbicides development programme: engaging the community in the standard of care debate in a vaginal microbicide trial in Mwanza, Tanzania.

    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

    authors: Vallely A,Shagi C,Lees S,Shapiro K,Masanja J,Nikolau L,Kazimoto J,Soteli S,Moffat C,Changalucha J,McCormack S,Hayes RJ

    更新日期:2009-10-09 00:00:00

  • Co-design and implementation research: challenges and solutions for ethics committees.

    abstract:BACKGROUND:Implementation science research, especially when using participatory and co-design approaches, raises unique challenges for research ethics committees. Such challenges may be poorly addressed by approval and governance mechanisms that were developed for more traditional research approaches such as randomised...

    journal_title:BMC medical ethics

    pub_type: 杂志文章

    doi:10.1186/s12910-015-0072-2

    authors: Goodyear-Smith F,Jackson C,Greenhalgh T

    更新日期:2015-11-16 00:00:00

  • Personalized assent for pediatric biobanks.

    abstract::Pediatric biobanking is considered important for generating biomedical knowledge and improving (pediatric) health care. However, the inclusion of children's samples in biobanks involves specific ethical issues. One of the main concerns is how to appropriately engage children in the consent procedure. We suggest that c...

    journal_title:BMC medical ethics

    pub_type: 杂志文章

    doi:10.1186/s12910-016-0142-0

    authors: Giesbertz NA,Melham K,Kaye J,van Delden JJ,Bredenoord AL

    更新日期:2016-10-12 00:00:00

  • Confidentiality breaches in clinical practice: what happens in hospitals?

    abstract:BACKGROUND:Respect for confidentiality is important to safeguard the well-being of patients and ensure the confidence of society in the doctor-patient relationship. The aim of our study is to examine real situations in which there has been a breach of confidentiality, by means of direct observation in clinical practice...

    journal_title:BMC medical ethics

    pub_type: 杂志文章

    doi:10.1186/s12910-016-0136-y

    authors: Beltran-Aroca CM,Girela-Lopez E,Collazo-Chao E,Montero-Pérez-Barquero M,Muñoz-Villanueva MC

    更新日期:2016-09-02 00:00:00

  • Developing an ethics support tool for dealing with dilemmas around client autonomy based on moral case deliberations.

    abstract:BACKGROUND:Moral Case Deliberations (MCDs) are reflective dialogues with a group of participants on their own moral dilemmas. Although MCD is successful as clinical ethics support (CES), it also has limitations. 1. Lessons learned from individual MCDs are not shared in order to be used in other contexts 2. Moral learni...

    journal_title:BMC medical ethics

    pub_type: 杂志文章

    doi:10.1186/s12910-018-0335-9

    authors: Hartman LA,Metselaar S,Molewijk AC,Edelbroek HM,Widdershoven GAM

    更新日期:2018-12-22 00:00:00

  • Ethical considerations in forensic genetics research on tissue samples collected post-mortem in Cape Town, South Africa.

    abstract:BACKGROUND:The use of tissue collected at a forensic post-mortem for forensic genetics research purposes remains of ethical concern as the process involves obtaining informed consent from grieving family members. Two forensic genetics research studies using tissue collected from a forensic post-mortem were recently ini...

    journal_title:BMC medical ethics

    pub_type: 杂志文章

    doi:10.1186/s12910-017-0225-6

    authors: Heathfield LJ,Maistry S,Martin LJ,Ramesar R,de Vries J

    更新日期:2017-11-29 00:00:00

  • Public appraisal of government efforts and participation intent in medico-ethical policymaking in Japan: a large scale national survey concerning brain death and organ transplant.

    abstract:BACKGROUND:Public satisfaction with policy process influences the legitimacy and acceptance of policies, and conditions the future political process, especially when contending ethical value judgments are involved. On the other hand, public involvement is required if effective policy is to be developed and accepted. M...

    journal_title:BMC medical ethics

    pub_type: 杂志文章

    doi:10.1186/1472-6939-6-1

    authors: Sato H,Akabayashi A,Kai I

    更新日期:2005-01-20 00:00:00

  • Ethical competence in DNR decisions -a qualitative study of Swedish physicians and nurses working in hematology and oncology care.

    abstract:BACKGROUND:DNR decisions are frequently made in oncology and hematology care and physicians and nurses may face related ethical dilemmas. Ethics is considered a basic competence in health care and can be understood as a capacity to handle a task that involves an ethical dilemma in an adequate, ethically responsible man...

    journal_title:BMC medical ethics

    pub_type: 杂志文章

    doi:10.1186/s12910-018-0300-7

    authors: Pettersson M,Hedström M,Höglund AT

    更新日期:2018-06-19 00:00:00

  • Will my patients get their residence permit? A critical analysis of the ethical dilemmas involved in writing medical certificates for residence permits in France.

    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

    authors: Cailhol J,Lebon MC,Sherlaw W

    更新日期:2020-07-13 00:00:00

  • Ethics of health research with prisoners in Canada.

    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

    authors: Silva DS,Matheson FI,Lavery JV

    更新日期:2017-04-27 00:00:00

  • Good health checks according to the general public; expectations and criteria: a focus group study.

    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

    authors: Stol YH,Asscher ECA,Schermer MHN

    更新日期:2018-06-22 00:00:00

  • Dying well with reduced agency: a scoping review and thematic synthesis of the decision-making process in dementia, traumatic brain injury and frailty.

    abstract:BACKGROUND:In most Anglophone nations, policy and law increasingly foster an autonomy-based model, raising issues for large numbers of people who fail to fit the paradigm, and indicating problems in translating practical and theoretical understandings of 'good death' to policy. Three exemplar populations are frail olde...

    journal_title:BMC medical ethics

    pub_type: 杂志文章,评审

    doi:10.1186/s12910-016-0129-x

    authors: Birchley G,Jones K,Huxtable R,Dixon J,Kitzinger J,Clare L

    更新日期:2016-07-27 00:00:00

  • The relationship between the perception of open disclosure of patient safety incidents, perception of patient safety culture, and ethical awareness in nurses.

    abstract:BACKGROUND:Scientific advances have resulted in more complex medical systems, which in turn have led to an increase in the number of patient safety incidents (PSIs). In this environment, the importance of honest disclosure of PSIs is rising, which highlight the need to settle a reliable system. This study aimed to inve...

    journal_title:BMC medical ethics

    pub_type: 杂志文章

    doi:10.1186/s12910-020-00546-7

    authors: Kim Y,Lee E

    更新日期:2020-10-27 00:00:00

  • Implementing clinical ethics committees as a complex intervention: presentation of a feasibility study in community care.

    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 CEC...

    journal_title:BMC medical ethics

    pub_type: 杂志文章

    doi:10.1186/s12910-020-00522-1

    authors: Magelssen M,Karlsen H,Pedersen R,Thoresen L

    更新日期:2020-09-01 00:00:00

  • Identification of ethics committees based on authors' disclosures: cross-sectional study of articles published in the European Journal of Anaesthesiology and a survey of ethics committees.

    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

    authors: Zoccatelli D,Tramèr MR,Elia N

    更新日期:2018-06-08 00:00:00

  • Saudi views on consenting for research on medical records and leftover tissue samples.

    abstract:BACKGROUND:Consenting for retrospective medical records-based research (MR) and leftover tissue-based research (TR) continues to be controversial. Our objective was to survey Saudis attending outpatient clinics at a tertiary care hospital on their personal preference and perceptions of norm and current practice in rela...

    journal_title:BMC medical ethics

    pub_type: 杂志文章

    doi:10.1186/1472-6939-11-18

    authors: Al-Qadire MM,Hammami MM,Abdulhameed HM,Al Gaai EA

    更新日期:2010-10-18 00:00:00

  • The emergence of ethical issues in the provision of online sexual health outreach for gay, bisexual, two-spirit and other men who have sex with men: perspectives of online outreach workers.

    abstract:BACKGROUND:Mobile applications and socio-sexual networking websites are used by outreach workers to respond synchronously to questions and provide information, resources, and referrals on sexual health and STI/HIV prevention, testing, and care to gay, bisexual and other men who have sex with men (GB2M). This explorator...

    journal_title:BMC medical ethics

    pub_type: 杂志文章

    doi:10.1186/s12910-017-0216-7

    authors: Fantus S,Souleymanov R,Lachowsky NJ,Brennan DJ

    更新日期:2017-11-03 00:00:00

  • A framework for the ethical assessment of chimeric animal research involving human neural tissue.

    abstract:BACKGROUND:Animal models of human diseases are often used in biomedical research in place of human subjects. However, results obtained by animal models may fail to hold true for humans. One way of addressing this problem is to make animal models more similar to humans by placing human tissue into animal models, renderi...

    journal_title:BMC medical ethics

    pub_type: 杂志文章

    doi:10.1186/s12910-019-0345-2

    authors: Porsdam Mann S,Sun R,Hermerén G

    更新日期:2019-01-25 00:00:00

  • Giving samples or "getting checked": measuring conflation of observational biospecimen research and clinical care in Latino communities.

    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

    authors: Knerr S,Ceballos RM

    更新日期:2015-07-17 00:00:00

  • Documentation of best interest by intensivists: a retrospective study in an Ontario critical care unit.

    abstract:BACKGROUND:Intensive care physicians often must rely on substitute decision makers to address all dimensions of the construct of "best interest" for incapable, critically ill patients. This task involves identifying prior wishes and to facilitate the substitute decision maker's understanding of the incapable patient's ...

    journal_title:BMC medical ethics

    pub_type: 杂志文章

    doi:10.1186/1472-6939-11-1

    authors: Ratnapalan M,Cooper AB,Scales DC,Pinto R

    更新日期:2010-02-10 00:00:00

  • Promoting advance planning for health care and research among older adults: a randomized controlled trial.

    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

    authors: Bravo G,Arcand M,Blanchette D,Boire-Lavigne AM,Dubois MF,Guay M,Hottin P,Lane J,Lauzon J,Bellemare S

    更新日期:2012-01-05 00:00:00

  • Attitudes towards assisted suicide and euthanasia among care-dependent older adults (50+) in Austria: the role of socio-demographics, religiosity, physical illness, psychological distress, and social isolation.

    abstract:BACKGROUND:Care-dependency constitutes an important issue with regard to the approval of end-of-life decisions, yet attitudes towards assisted suicide and euthanasia are understudied among care-dependent older adults. We assessed attitudes towards assisted suicide and euthanasia and tested empirical correlates, includi...

    journal_title:BMC medical ethics

    pub_type: 杂志文章

    doi:10.1186/s12910-017-0233-6

    authors: Stolz E,Mayerl H,Gasser-Steiner P,Freidl W

    更新日期:2017-12-07 00:00:00

  • Complexity of consenting for medical termination of pregnancy: prospective and longitudinal study in Paris.

    abstract:BACKGROUND:We analyzed the patients' perception of prenatal diagnosis of fetal cardiac pathology, and the reasons for choosing to continue with pregnancy despite being eligible to receive a medical termination of pregnancy. We also identified the challenges, the motives interfering in decision-making, and the consequen...

    journal_title:BMC medical ethics

    pub_type: 杂志文章

    doi:10.1186/s12910-018-0270-9

    authors: Abi Tayeh G,Jouannic JM,Mansour F,Kesrouani A,Attieh E

    更新日期:2018-05-02 00:00:00

  • Culture and personal influences on cardiopulmonary resuscitation- results of international survey.

    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

    authors: Ozer J,Alon G,Leykin D,Varon J,Aharonson-Daniel L,Einav S

    更新日期:2019-12-26 00:00:00

  • Convergent ethical issues in HIV/AIDS, tuberculosis and malaria vaccine trials in Africa: Report from the WHO/UNAIDS African AIDS Vaccine Programme's Ethics, Law and Human Rights Collaborating Centre consultation, 10-11 February 2009, Durban, South Africa

    abstract:BACKGROUND:Africa continues to bear a disproportionate share of the global HIV/AIDS, tuberculosis (TB) and malaria burden. The development and distribution of safe, effective and affordable vaccines is critical to reduce these epidemics. However, conducting HIV/AIDS, TB, and/or malaria vaccine trials simultaneously in ...

    journal_title:BMC medical ethics

    pub_type: 杂志文章

    doi:10.1186/1472-6939-11-3

    authors: Mamotte N,Wassenaar D,Koen J,Essack Z

    更新日期:2010-03-09 00:00:00

  • "Media, politics and science policy: MS and evidence from the CCSVI Trenches".

    abstract:BACKGROUND:In 2009, Dr. Paolo Zamboni proposed chronic cerebrospinal venous insufficiency (CCSVI) as a possible cause of multiple sclerosis (MS). Although his theory and the associated treatment ("liberation therapy") received little more than passing interest in the international scientific and medical communities, hi...

    journal_title:BMC medical ethics

    pub_type: 杂志文章

    doi:10.1186/1472-6939-14-6

    authors: Pullman D,Zarzeczny A,Picard A

    更新日期:2013-02-12 00:00:00

  • What makes public health studies ethical? Dissolving the boundary between research and practice.

    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

    authors: Willison DJ,Ondrusek N,Dawson A,Emerson C,Ferris LE,Saginur R,Sampson H,Upshur R

    更新日期:2014-08-08 00:00:00

  • Knowledge and attitudes to personal genomics testing for complex diseases among Nigerians.

    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

    authors: Fagbemiro L,Adebamowo C

    更新日期:2014-04-27 00:00:00

  • Obtaining subjects' consent to publish identifying personal information: current practices and identifying potential issues.

    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

    authors: Yoshida A,Dowa Y,Murakami H,Kosugi S

    更新日期:2013-11-25 00:00:00