Bioethics Education Research Articles

Developing a Postpandemic Model for Hybrid Clinical Ethics Rotations in Postgraduate Medical Education.

Bioethics education in residency helps trainees achieve many of the Accreditation Council for Graduate Medical Education milestones and gives them resources to respond to bioethical dilemmas. For this purpose, The Providence Center for Health Care Ethics has offered a robust clinical ethics rotation since 2000. The importance of bioethics for residents was highlighted as the COVID-19 pandemic raised significant bioethical concerns and moral distress for residents. This, combined with significant COVID-19-related practical stressors on residents led us to develop a virtual ethics rotation. A virtual rotation allowed residents flexibility as they were called to help respond to the unprecedented demands of a pandemic without compromising high quality education. This virtual rotation prioritized flexibility to support resident wellbeing and ethical analysis of resident experiences. This article describes how this rotation was able to serve residents without overstraining limited bandwidth, and address the loci of resident pandemic distress. As pandemic pressures lessened, The Providence Center for Health Care Ethics transitioned to a hybrid rotation which continues to prioritize resident wellbeing and analysis of ongoing stressors while incorporating in-person elements where they can improve learning. This article provides a description of the rotation in its final form and resident feedback on its effectiveness.

Deliberation in bioethics education: a literature scoping review

Deliberation in bioethics education: a literature scoping review

The Impact of a Study Trip to Auschwitz: Place-based Learning for Bioethics Education and Professional Identity Formation.

There are increasing calls for coverage of medicine during the Holocaust in medical school curricula. This article describes outcomes from a Holocaust and medicine educational program featuring a study trip to Poland, which focused on physician complicity during the Holocaust, as well as moral courage in health professionals who demonstrated various forms of resistance in the ghettos and concentration camps. The trip included tours of key sites in Krakow, Oswiecim, and the Auschwitz-Birkenau concentration camps, as well as meeting with survivors, lectures, reflective writings, and discussions. In-depth interviews and reflective writings were qualitatively analyzed. Resulting themes centered on greater understanding of the relationship between bioethics and the Holocaust, recognizing the need for moral courage and social awareness, deeper appreciation for the historical roles played by dehumanization and medical power and their contemporary manifestations, and the power of presence and experiential learning for bioethics education and professional identity formation. These findings evidence the significant impact of the experience and suggest broader adoption of pedagogies that include place-based and experiential learning coupled with critical reflection can amplify the impact of bioethics and humanism education as well as the process of professional identity formation of medical students.

Infectious diseases ethics: a worldwide survey

ObjectivesCOVID-19 unravelled new ethical issues in the neglected field of infectious diseases ethics (IDE). We investigated IDE involvement among infectious diseases professionals. MethodsA global survey was disseminated during 2021–2022. Responses were stratified by demographics, WHO region, income, and ethics training. A confirmatory factor analysis was used to identify two themes representing IDE relevant areas (theme 1, including stigma, inequity, vulnerability, public health, and global impact) and emerging topics (theme 2, including inequity and research integrity in COVID-19, increased ethics interest, and gaps in IDE). Quantile and logistic regression analyses investigated determinants of ethics themes and responders' ethics attitude. ResultsWe included 477 participants from 71 countries. Most were females (282/460, 61%) and clinicians (327/457, 72%). Participants advocated further personal (289/443, 65%) or societies' (374/450, 83%) involvement in bioethics. Only 5% (22/477) of respondents claimed to have received enough bioethics training and 28% (114/412) were dissatisfied with it. Dedicated courses or expert case discussion were the preferred ways for receiving education in bioethics. Theme 1 and 2 median values were above 7 (on a 1–10 scale), showing high interest in IDE. Confirmatory factor analysis showed optimal and acceptable fit, respectively. Being from the region of Americas was associated with theme 1, whereas having received bioethics training was associated with both themes. Females, respondents trained in bioethics, and those from the Americas and Europe regions reported lower involvement in bioethics activities, whereas those aged between 44 and 54 years and trained in bioethics were more involved. Age above 55 years and nonclinical role were negatively associated with aspiration for further bioethics involvement. DiscussionWe identified IDE themes that can inform on gaps in bioethics. Ethics training was associated with interest in IDE and bioethics activities and should be offered to integrate this discipline into daily clinical practice across age, gender, and different areas worldwide.

The current status and challenges of bioethics education in undergraduate medical education in Karachi, Pakistan

BackgroundThe importance of including bioethics in the medical curricula has been recognized globally. Certain countries including Pakistan continue to lag behind although some developments have occurred recently.ObjectivesThe research aimed to provide a snapshot of bioethics education in undergraduate medical colleges in Karachi, Pakistan. The secondary objectives included identifying factors promoting or inhibiting integration of bioethics into the curriculum.MethodsA two-pronged strategy was used to collect data including a website review of medical colleges, in existence for more than ten years, recognized by the Pakistan Medical and Dental Council (PMDC), the regulating body for undergraduate medical education in Pakistan. The other arm employed in-depth interviews with medical educationists in colleges fulfilling inclusion criteria. Data from the website was analyzed and presented as frequencies. Qualitative data was analyzed using content analysis method which involved coding of transcripts, multiple readings and arriving at subthemes and themes iteratively.ResultsThirteen medical colleges were included for the website review, of which four were from public sector. Three medical colleges used the word “ethics” in their vision and mission statement and four had provided a detailed curriculum for ethics on their website.Thematic framework included four broad themes: 1) Need for Bioethics Education, 2) Current Status of Bioethics Education 3) Challenges in integration of bioethics in medical curriculum and 4) Recommendations for integration of bioethics in the Curriculum. Participants were in agreement that bioethics was important in development of future physicians. Participants identified various challenges, foremost being shortage of trained faculty, lack of institutional buy-in and overcrowded curriculum.ConclusionThe study identified sporadic inclusion of bioethics in undergraduate medical curricula, left to the discretion of individual institutions. Since Karachi is a cosmopolitan city, the findings may reasonably reflect the situation in other parts of the country. While bioethics is recognized as an important field, it will continue to remain an orphan subject in the curricula unless the regulatory and accreditation bodies make it compulsory for institutions to include ethics in their curricula.

Graduate teaching reform on synthetic biology featuring the discipline of fermentation engineering

Industrial biotechnology is regarded as the most promising technology for sustainable industrial development. The advancement of synthetic biology creates new opportunities and infinite possibilities for the progress of industrial biotechnology. Fermentation engineering is the grab and foothold of the industrialization of all the biotechnologies. Our teaching team optimized the teaching content and innovated the teaching mode to establish a teaching system of synthetic biology matching fermentation engineering. We highlighted the teaching characteristics (telling fermentation story cultivated the craftsmanship spirit; bioeconomic education strengthened the engineering thinking; bioethics and safety education fostered a sense of responsibility), then we summarized and prospected the teaching reform of this course. We believe that the teaching reform of synthetic biology will improve the learning performance of postgraduates, provide a reference for the teaching of synthetic biology in related fields, and promote the development of industrial biotechnology (strengthening the innovation capability in biological manufacturing and cultivating new momentum for bioeconomy).

Teaching of bioethics in the field of medical and biological sciences: The situation in Algeria

Teaching of bioethics in the field of medical and biological sciences: The situation in Algeria

Project-based learning in bioethics education

Project-based learning in bioethics education

Addressing Barriers and Facilitators to African Americans’ and Hispanics’ Participation in Clinical and Genomic Research Through a Bioethical Sensitive Video

Research advances on effective methods to prevent, diagnose, and treat cancer continue to emerge through clinical and genomic research. Most clinical trial and genomic research participants identify as White which limits the generalizability of research findings to non-White populations. With the development and access to technology, digital delivery of salient and tailored health education may provide innovative pathways to increase representation of African Americans (AA) and Hispanics in research. This project focused on the creation of a bioethical sensitive education video aimed at increasing participation in clinical trials and genomic research by bringing together experts from the community, healthcare, biomedical research, and public health. The goal was to utilize existing educational resources to create a tailored message to address AA/Hispanics’ beliefs, values, and bioethical concerns related to participation in clinical and genomic research. Models of behavior change and communication theories were leveraged to frame key components of the message, which then informed the framework for the animated video. Development of the video consisted of six iterative phases: 1) writing sessions; 2) storyboarding; 3) animating; 4) screening/revisions; 5) acceptability testing; 6) finalization. The final animated video is approximately 5 min in length and covers several topics including the goal of clinical research, disparities in research participation, bioethical concerns, and genomic research regulations. Increasing AA and Hispanic participation in clinical and genomic research is imperative to achieving health equity. Tailored messages via short videos may assist in addressing the barriers and facilitators towards research participation and increase intentions to enroll in trials.

Teaching humanism with humanoid: evaluating the potential of ChatGPT-4 as a pedagogical tool in bioethics education using validated clinical case vignettes

Teaching humanism with humanoid: evaluating the potential of ChatGPT-4 as a pedagogical tool in bioethics education using validated clinical case vignettes

Bioethics curriculum for undergraduate medical students: an evaluation study utilizing mixed methods approach

BackgroundThe undergraduate bioethics curriculum introduced in a private medical college in Pakistan in 1988 and revised in 2009 has evolved over time to incorporate globally relevant innovations, including integration of bioethics spirally within an existing problem-based learning curricular framework. The present evaluation study shares the results of this integrated bioethics curriculum delivered for 10 years across the five-year undergraduate medical curriculum. The study assessed the effectiveness of the curriculum in terms of student achievement, appropriateness of course contents and efficiency of instructional methods.MethodsThe study utilized a mixed method sequential explanatory design. The quantitative method was used in the first phase to gather data by utilizing a structured online questionnaire. This was followed by the second phase of qualitative methods to explain the findings of the first phase and enrich the data gathered. This phase was based on focus group discussions and document review.ResultsStudent and faculty responses showed the curriculum contents to be relevant, informative, and appropriate as per learning objectives and student achievement. Multi-modal instructional methods used were stated to be effective and engaging; small group teaching and shorter sessions suggested to be preferable for fostering discussion and maintaining student engagement and attention. Large class formats were stated to be less effective. Students affirmed the contribution of bioethics education to their personal and professional development and ethical positioning. The majority of students agreed that the curriculum contributed to their knowledge acquisition (60.3—71.2%), skill development (59.41—60.30%) and demonstration of ethical/professional behavior (62.54—67.65%). The ranges indicate agreement with related sets of questions.Participants suggested that the curriculum could be further strengthened by better integration in clinical years, role modelling and providing opportunities for application in clinical health care settings. Moreover, topics like ethical issues related to the use of social media, public health ethics and ethics and law were suggested as additions to the existing curriculum. These findings have regional and global relevance for the development and assessment of effective bioethics curricula.ConclusionAn effective bioethics curriculum for undergraduate medical education should run longitudinally across the 5 year curriculum and be integrated in the modules and clerkships. Basic acquisition of knowledge and skills takes place in Years 1 & 2 with reinforcement and application in Years 3–5. Learning embedded in an integrated curriculum can help students recognize, critically analyze and address ethical dilemmas. Involvement and commitment of the clinical faculty is essential for reinforcing the ethical principles and concepts learnt in the earlier years.

How patients experience respect in healthcare: findings from a qualitative study among multicultural women living with HIV

BackgroundRespect is essential to providing high quality healthcare, particularly for groups that are historically marginalized and stigmatized. While ethical principles taught to health professionals focus on patient autonomy as the object of respect for persons, limited studies explore patients’ views of respect. The purpose of this study was to explore the perspectives of a multiculturally diverse group of low-income women living with HIV (WLH) regarding their experience of respect from their medical physicians.MethodsWe analyzed 57 semi-structured interviews conducted at HIV case management sites in South Florida as part of a larger qualitative study that explored practices facilitating retention and adherence in care. Women were eligible to participate if they identified as African American (n = 28), Hispanic/Latina (n = 22), or Haitian (n = 7). They were asked to describe instances when they were treated with respect by their medical physicians. Interviews were conducted by a fluent research interviewer in either English, Spanish, or Haitian Creole, depending on participant’s language preference. Transcripts were translated, back-translated and reviewed in entirety for any statements or comments about “respect.” After independent coding by 3 investigators, we used a consensual thematic analysis approach to determine themes.ResultsResults from this study grouped into two overarching classifications: respect manifested in physicians’ orientation towards the patient (i.e., interpersonal behaviors in interactions) and respect in medical professionalism (i.e., clinic procedures and practices). Four main themes emerged regarding respect in provider’s orientation towards the patient: being treated as a person, treated as an equal, treated without blame or prejudice, and treated with concern/emotional support. Two main themes emerged regarding respect as evidenced in medical professionalism: physician availability and considerations of privacy.ConclusionsFindings suggest a more robust conception of what ‘respect for persons’ entails in medical ethics for a diverse group of low-income women living with HIV. Findings have implications for broadening areas of focus of future bioethics education, training, and research to include components of interpersonal relationship development, communication, and clinic procedures. We suggest these areas of training may increase respectful medical care experiences and potentially serve to influence persistent and known social and structural determinants of health through provider interactions and health care delivery.

ASSESSMENT OF KNOWLEDGE, ATTITUDE AND PRACTICES REGARDING BIOETHICS AMONG STUDENTS IN DENTAL INSTITUTES OF PUNJAB

This cross-sectional study aimed to evaluate the levels of knowledge, attitudes, and practices (KAP) regarding bioethics among students enrolled in dental institutes across Punjab, India. A sample size of 202 students, including those exposed to clinical settings, participated in the study. A structured questionnaire was used to assess participants understanding of bioethical principles, their attitudes towards ethical dilemmas commonly encountered in dental practice, and their adherence to ethical standards in clinical settings. The findings revealed varying levels of knowledge among students, with notable disparities in understanding specific bioethical principles. Attitudinal responses highlighted a generally positive disposition towards ethical decision-making, although some students demonstrated uncertainty in navigating complex ethical scenarios. Furthermore, the study uncovered variations in the implementation of ethical practices among students in clinical settings. These findings underscore the importance of integrating comprehensive bioethics education within dental curricula to foster ethical awareness, enhance moral reasoning skills, and promote ethical conduct among future dental practitioners. Addressing these gaps in knowledge, attitudes, and practices is crucial for the cultivation of a morally conscious dental workforce capable of upholding the highest ethical standards in patient care and professional conduct.

Fetal Cardiology Bioethics: An Innovative New Curriculum for Cardiology Trainees.

Decision-making in fetal cardiology is fraught with ethical issues yet education in bioethics for trainees is limited or nonexistent. In this innovation report, we describe the development of a fetal cardiologybioethics curriculum designed to address this gap. The curriculum was developed to supplement the core curriculum for cardiology fellows and fetal cardiology subspecialty trainees. The series combines didactic and interactive teaching modalities and contains 5 key components: (1) introduction to bioethics and its role in fetal cardiology, (2) counseling and pathways for compassionate terminal care, (3) case vignette-based ethical analysis and discussion cases, (4) fetal counseling considerations for shared decision-making and recommendations, (5) facilitated communications role play. The curriculum was refined using session evaluations from end users. This report describes the innovative curriculum as a starting point for further incorporation and study of bioethical education in pediatric cardiology and fetal training programs.

Gaps in medical school in the approach to ethics, bioethics, and palliative care: a challenge for professional training

Medical education requires discipline, effort, and dedication for professional improvement, which complies with the requirement for vast, dynamic knowledge, including (bio)technologies in diagnostics and therapeutics. However, this process does not ensure the appropriate human training of health professionals to deal with an abrupt demographic transition of older people with several comorbidities as well as with an increase in life expectancy and in the risk of serious health-related suffering. There is a gap in bioethics education offered to undergraduate medical students, especially in bioethical principles (not only those related to biomedical and deontological ethics), which must be bridged before good communication, attitudes, behaviors, and, particularly, better decision-making can be demanded from medical actions. The advent of chronic and incurable diseases in recent decades has contributed to strengthening the hospice movement toward patient-centered care, highlighting an unmet demand for palliative care in the face of progressive, advanced, and critical conditions. Thus, personalism, a contemporary bioethical trend, in line with the principles of palliative care, calls for human training in bioethics by demonstrating the challenges of disease-focused care amidst the conflicts generated by biotechnoscience to provide comprehensive integrated patient-centered care.

Public health and research ethics education: the experience of developing a new cadre of bioethicists at a Ugandan institution

Research ethics education is critical to developing a culture of responsible conduct of research. Many countries in sub-Saharan Africa (SSA) have a high burden of infectious diseases like HIV and malaria; some, like Uganda, have recurring outbreaks. Coupled with the increase in non-communicable diseases, researchers have access to large populations to test new medications and vaccines. The need to develop multi-level capacity in research ethics in Uganda is still huge, being compounded by the high burden of disease and challenging public health issues. Only a few institutions in the SSA offer graduate training in research ethics, implying that the proposed ideal of each high-volume research ethics committee having at least one member with in-depth training in ethics is far from reality. Finding best practices for comparable situations and training requirements is challenging because there is currently no “gold standard” for teaching research ethics and little published information on curriculum and implementation strategies. The purpose of this paper is to describe a model of research ethics (RE) education as a track in an existing 2-year Master of Public Health (MPH) to provide training for developing specific applied learning skills to address contemporary and emerging needs for biomedical and public health research in a highly disease-burdened country. We describe our five-year experience in successful implementation of the MPH-RE program by the Mbarara University Research Ethics Education Program at Mbarara University of Science and Technology in southwestern Uganda. We used curriculum materials, applications to the program, post-training and external evaluations, and annual reports for this work. This model can be adapted and used elsewhere in developing countries with similar contexts. Establishing an interface between public health and research ethics requires integration of the two early in the delivery of the MPH-RE program to prevent a disconnect in knowledge between research methods provided by the MPH component of the MPH-RE program and for research in ethics that MPH-RE students are expected to perform for their dissertation. Promoting bioethics education, which is multi-disciplinary, in institutions where it is still “foreign” is challenging and necessitates supportive leadership at all institutional levels.

Pregnancy, Childbirth, and Religion in Bioethical Education: One Proposition

Pregnancy, Childbirth, and Religion in Bioethical Education: One Proposition

간호대학생의 생명의료윤리 원칙 인식에 대한 분석

Objectives This study was attempted to identify and systematically understand how nursing students perceive the principles of biomedical ethics.
 Methods Through an open questionnaire, first-year nursing students who took a biomedical ethics lecture for one semester were asked to choose the most important principle among the four principles of biomedical ethics and write the rationale for it. A total of 99 subjects were analyzed using the content analysis method.
 Results Among the four biomedical ethics principles, the importance distribution was shown in the order of prin-ciple of respect for autonomy(45.5%), principle of nonmaleficence(29.3%), principle of beneficence(20.2%), and principle of justice(5.0%), and 14 themes and 42 statements supporting the basis were revealed. There were a total of 15 statements on the principle of respect for autonomy, and 4 themes were included: inherent rights, right to choose, right to know, and right to be respected(45.5%). There were a total of 15 statements on the principle of nonmaleficence, including 4 themes: avoiding harm, minimizing suffering, basic duties, and licensing as a nurse(29.3%). There were a total of 9 statements on the principle of beneficence, and 4 themes were included: the role of medical personnel, use of professional knowledge, active help, and human well-being(20.2%). There were a total of 3 statements on the principle of justice, including 2 themes: establishment of standards and fair-ness(5.0%).
 Conclusions It was confirmed that the students showed an active attitude to solidify their moral values and to cul-tivate a sense of ethics. In the undergraduate curriculum, not teacher-centered lectures, but learner-centered bi-oethics education that reflects students' understanding and feedback should be provided.

Экологический сетевой подход в приложении к биоэтическим организационным структурам

The term ‘bioethics’ (in the narrow sense) or ‘biomedical ethics’ denotes medical ethics at the modern stage of development. Bioethics is currently institutionalized and falls under the responsibility of specialized organizational structures (bioethics commissions, ‘divine committees’, etc.). The article expounds the prospects of applying network structures to institutions and organizations dealing with bioethical issues and tasks (ethical aspects of reproductive technologies, biomedical experiments, organ transplantation, and bioethical education). With the principles of decentralization (‘multiple authority’) and ecology (an integrative approach to issues under study and integrity of a bioethical expert team), network structures promote creative and effective functioning of bioethical organizations. Nonetheless, the centralized hierarchies of traditional educational and research institutions are also expected to perform essential functions. A reasonable combination of network structures and hierarchies provides the latter with a new role: the hierarchies assess the activity of emergent network structures using competent experts and provide selective support (including financing) to the most effective among them.

Educação Baseada em Competências e o Ensino da bioética num curso técnico de radiologia médica

Currently, an ethical perspective in professional training is essential. In health courses, a fundamental aspect is the learning of bioethics, a perspective that critically analyzes problem situations and socio-scientific themes through an interdisciplinary perspective. This field of knowledge is related to that proposed by a Common National Curricular Base (BNCC) in the area of Natural Sciences and its Technologies. The objective of this work, the result of a master's dissertation, was to apply a didactic sequence in the discipline “Ethics” of a technical course in the health area with the intention of facilitating the teaching of bioethics together with the development of the transversal competence of ethics, for through Competency-Based Education (EBC). The design consisted of a descriptive case study. The target audience was composed of 32 students, from the 1st module of a radiology technical course from a private institution located in the interior of the State of São Paulo. The results showed that the didactic sequence facilitated the teaching of bioethics and helped in the development of ethics as a transversal competence. Greater scientific literacy of students was perceived, a greater understanding of interdisciplinarity in this field of saber, the development of different behavioral skills and criticality and awareness in self-assessments. It is concluded that the teaching of bioethics through EBC can assist in ethical training and stimulate transversal resources in students.