Ethical Principles In Health Care Research Articles

Factors Influencing Nurses’ Intentions to Protect Patient Privacy: A Survey-Based Study Using the Theory of Planned Behavior

Background and Purpose:Patient privacy and confidentiality are fundamental ethical principles in healthcare. Protecting patient privacy, which is accepted as a patient’s right, is one of the responsibilities of nurses. Few studies on patient privacy among nurses have used social cognitive approaches. The purpose of this study is to examine nurses’ intentions to protect patient privacy using the theory of planned behavior (TPB).Methods:This is a cross-sectional and correlational design study. The study sample consisted of 202 nurses working in the emergency departments, operating rooms, inpatient wards, and intensive care units of the hospitals. Research data were collected using a face-to-face questionnaire that included TPB components on patient privacy. The proposed research model was tested using structural equation modeling.Results:Attitude (β= .238,p< .05), subjective norm (β= .295,p< .05), and moral norm (β= .337,p< .05) toward patient privacy are positive predictors of intention. The moral norm is the most effective component of intention. Perceived behavioral control is not a significant predictor of intention (β= .049,p> .05).Implications for Practice:Norms that create a sense of moral obligation in nurses are a significant determinant in increasing the intention to protect patient privacy. Interventions that improve moral norms, attitudes, and subjective norms will increase the intention to protect privacy. Nurse managers should provide nurses with adequate skills, resources, and an appropriate work environment to ensure perceived behavioral control regarding patient privacy.

Ethical Considerations in AI-assisted Decision- Making for End-Of-Life Care in Healthcare.

This paper delves into the ethical implications of deploying artificial intelligence (AI) in decision-making processes related to end-of-life care within healthcare settings. As AI continues to advance, its integration in healthcare introduces both opportunities and challenges, particularly in navigating the sensitive realm of end-of-life care. The paper explores this intersection, seeking to contribute valuable insights to the ongoing discourse on responsible AI implementation in the healthcare sector. Central to ethical considerations in end-of-life care is the principle of autonomy, emphasizing the importance of respecting patients' ability to make informed decisions about their care preferences. The paper argues for the need to design AI systems that augment rather than diminish patient autonomy, ensuring that individuals facing end-of-life decisions remain active participants in the process. Furthermore, the principles of beneficence and non-maleficence are highlighted, emphasizing the imperative for AI systems to enhance patient well-being while minimizing the risk of harm, both physical and psychological. Justice in the distribution of healthcare resources, including AI technologies, is crucial, and the paper emphasizes the need to address potential disparities in access. Transparent and explainable AI systems are advocated to foster trust among patients, families, and healthcare providers, enabling a better understanding of the rationale behind AI-driven recommendations. [1] The concept of accountability is explored, emphasizing the continued responsibility of healthcare professionals in overseeing and validating AI recommendations to maintain ethical standards. Cultural sensitivity is identified as a key consideration, recognizing and respecting diverse perspectives on end-of-life care. The paper underscores the significance of designing AI systems that accommodate cultural nuances and avoid imposing values that may conflict with patients' beliefs and preferences. Additionally, the emotional and psychological impact of AI-assisted decision-making is addressed, emphasizing the importance of maintaining the human touch in end-of-life care and acknowledging the roles of empathy, compassion, and human connection. The paper provides a comprehensive examination of the ethical dimensions surrounding AI-assisted decision-making in end-of-life care. By addressing autonomy, beneficence, justice, transparency, accountability, cultural sensitivity, and emotional impact, it offers a framework for responsible AI integration that aligns with ethical principles in healthcare, ultimately contributing to the enhancement of end-of-life care practices.

BT08 Mapping UK frameworks for ethical artificial intelligence applied to dermatology

Abstract There is significant enthusiasm to apply artificial intelligence (AI) in dermatology with an emphasis on image-based analyses for risk assessment of suspicious skin lesions. However, the rapid development and deployment of such AI tools raises concerns that ethical issues arising from their widespread, long-term use may not have been adequately considered during design or implementation. Dermatology, in particular, has been identified as lacking sufficient bioethics research that could standardize the approach to regulating AI-assisted applications. Despite significant efforts to develop robust guidelines for ‘ethical AI’ across private, national and international organizations, debate continues surrounding which ethical principles should be included. The 2022 National AI Strategy positions the UK as leading global efforts toward achieving safe and ethical deployment of AI. We sought to systematically review and analyse policy documents to map UK principles for promoting ethical AI as applied to dermatology. Our review identified five UK policy documents relevant to ethical AI published between 2016 and 2022. All included frameworks highlighted the importance of upholding transparency and fairness along the entire lifecycle of AI development and decision-making. The five frameworks also incorporated autonomy through reference to maintaining informed consent, data privacy and human contestability of AI decisions. The principles of accountability and nonmaleficence were each identified in four policy documents, emphasizing the needs for clear definitions of legal and organizational responsibility and for thorough testing of AI tools to avoid unintended/unwanted outcomes. The principles of beneficence (designing AI to promote good on both individual and societal levels) and sustainability (continually monitoring and adjusting AI tools for longevity and efficacy) were each included in two policy documents. Current UK policy frameworks for ethical AI converge around five key values: fairness, transparency, autonomy, nonmaleficence and accountability. The principles of beneficence and sustainability were advanced, although less frequently highlighted. Despite a reassuring level of convergence across policy documents, the practical implementation of these ethical principles in health care and particularly for skin-specific AI tools remains unclear. Furthermore, evidence of real-world integration of these ethical frameworks into developing AI-based skin cancer diagnostic tools is lacking. Future work seeks to address this gap by analysing commercially available skin cancer diagnostic applications using predefined ethical themes to identify case-specific ethical issues and to evaluate the extent to which these issues are addressed within the existing ethical frameworks. This will provide guidance for developers and adopters of these tools, ensuring responsible design and deployment.

To Consent or Not to Consent to Screening, That Is the Question

The objective of this article is to address the controversial question of whether consent is relevant for persons invited to participate in screening programs. To do so, it starts by presenting a case where the provided information historically has not been sufficient for obtaining valid informed consent for screening. Then, the article investigates some of the most relevant biases that cast doubt on the potential for satisfying standard criteria for informed consent. This may indicate that both in theory and in practice, it can be difficult to obtain valid consent for screening programs. Such an inference is profoundly worrisome, as invitees to screening programs are healthy individuals most suited to make autonomous decisions. Thus, if consent is not relevant for screening, it may not be relevant for a wide range of other health services. As such, the lack of valid consent in screening raises the question of the relevance of one of the basic ethical principles in healthcare (respect for autonomy), one of the most prominent legal norms in health legislation (informed consent), and one of the most basic tenets of liberal democracies (individual autonomy). Thus, there are good reasons to provide open, transparent, and balanced information and minimize biases in order to ascertain informed consent in screening.

Healthcare professionals and COVID-19 in Morocco: accident at work or occupational disease?

L´abnégation et le sens de l´engagement au devoir sont des principes éthiques fondamentaux de la profession médicale. Depuis le début de la crise sanitaire, le personnel soignant fut le premier rempart contre la propagation du coronavirus, par conséquent, la catégorie professionnelle la plus exposée aux risques de contamination. A cet égard, dans un communiqué datant du 23 mars 2020, l´Organisation mondiale de la santé a recommandé la prise en charge -au titre de législation professionnelle- de la maladie provoquée par la COVID-19 pour les salariés du secteur médical, mais également ceux de tous les secteurs exposés aux risques de contamination. Au Maroc, le ministère de la Santé a publié le 6 avril, sur son site officiel, un communiqué de condoléance destiné aux familles des deux premiers médecins décédés à la suite de leur contraction du coronavirus tout en précisant que la cause du décès des deux médecins n´est pas due à l'exercice de leurs fonctions professionnelles. Le Ministre du travail et de l'insertion professionnelle a récemment chargé une commission interne d´entreprendre une réflexion sur cette question. Qu´en est-il à ce jour, compte tenu de l´assise juridique marocaine, de la possibilité de reconnaître le caractère professionnel de la maladie provoquée par le coronavirus?

Physicians' Attitudes Toward Adolescent Confidentiality Services: Scale Development and Validation.

IntroductionConfidentiality is one of the oldest ethical principles in healthcare. However, confidentiality in adolescent healthcare is not a universally-accepted doctrine among scholars. The ethical acceptability of confidential services in adolescents’ healthcare is based on perceptions of adolescent maturity and an appreciation of its importance to adolescents’ access and utilization of healthcare services. Despite legal policies that promote adolescents’ rights, physicians’ attitudes toward adolescent confidentiality can be a determining factor in their ultimate decision to protect adolescents’ confidentiality.MethodA new Attitude towards Adolescent Confidentiality Scale was developed based on the results of a qualitative interview study. This new instrument was administered to a sample of 152 physicians working at school pediatric and gynecology departments in 13 primary healthcare institutions in Belgrade. Principal component analysis was applied to determine the main components of the scale. Reliability was assessed by calculating Cronbach alpha and mean inter-item correlations.ResultsPsychometric analysis of the final 19-item version of the scale showed a high level of reliability (Cronbach alpha of 0.83). Principal component analysis showed four components, which present subscales of the instrument: Confidentiality in clinical situation, Iimportance of confidentiality, Adolescent maturity, and Communication with parents.ConclusionsThe instrument showed satisfactory levels of reliability and validity. The results of the scale dissemination may be a valuable tool for needs assessment for future educational interventions and training programs that will raise physicians’ awareness of the importance of adolescent confidentiality.

Design of a Platform to Discuss Ethical Considerations of Preimplantation Genetic Diagnosis: a Case for Integration of Ethics in Foundational Science Medical Curriculum

The creation of an integrated basic science curriculum is a major goal in medical education. However, there is little consensus on how this can be effectively accomplished. One route is to utilize clinical problems that integrate multiple disciplines. This study describes an approach to utilize a large group case-based discussion (CBD) integrating ethics and medical genetics that has been administered to two consecutive classes. In this CBD, first-year medical students were provided the opportunity to apply and transfer knowledge to a novel clinical scenario utilizing content previously covered in two courses (“Genes, Molecules and Cells” and “Ethical Foundations in Medicine”) that run concurrently. Students were presented with preimplantation genetic diagnosis results for an X-linked disorder and asked to decipher embryo genotypes and make group recommendations on which embryo(s) they would transfer to achieve a “healthy” pregnancy. In addition to genotype considerations, students were asked to consider the three fundamental ethical principles in healthcare and shared medical decision-making when making their embryo transfer recommendations. This study reports the details of the integrated activity, facilitator feedback, and discusses modifications made to the activity to improve integration and knowledge transfer. Furthermore, this study reports positive feedback from students for this integrated discipline CBD and a significant improvement in learning outcomes following the intervention.

Ethical principles in healthcare

Ethical principles in healthcare

Patients’ silence following healthcare staff’s ethical transgressions

The aim of this study was to examine to what extent patients remained silent to the health care system after they experienced abusive or wrongful incidents in health care. Female patients visiting a women's clinic in Sweden (n = 530) answered the transgressions of ethical principles in Health care questionnaire (TEP), which was constructed to measure patients' abusive experiences in the form of staff's transgressions of ethical principles in health care. Of all the patients, 63.6% had, at some point, experienced staff's transgressions of ethical principles, and many perceived these events as abusive and wrongful. Of these patients, 70.3% had remained silent to the health care system about at least one transgression. This silence is a loss of essential feedback for the health care system and should not automatically be interpreted as though patients are satisfied.

Ethical issues in optometric practice

Ethics as a discipline is the study and analysis of values and standards related to duty, responsibility, and right and wrong behavior. The ethical obligations of optometry toward patients are similar to those of other health professionals. These obligations generally require optometrists to recognize, respect, and protect the rights of their patients. This approach encourages patients to participate actively in their care and allows them to develop arelationship with their optometrist based on trust. The ethical codes which contain guiding principles serve to help practitioners in their decisions and in practicing in accordance with a set of standards that are expected of a health care practitioner. There are four major ethical principles in health care, namely; beneficence, non-maleficence, and respect for autonomy and justice. Because these principles are easily recognized as being among the primary ethical goals of health care, using them as the basis for ethical analysis may help to explain the moral justification for certain professional actions as well as to identify unethical behavior. However, in clinical practice, the specific demands and rationales of these broad principles may be difficult to apply. This illustrates the paradox that whilst these principles are essential tools for ethical practice, if applied too rigidly, they can be problematic. How-ever, the goal of ethical decision making in optometry should be to identify one or more courses of action that will honor the profession’s essential values while minimizing conflict with other values and professional standards. Every profession, every practice and every practitioner is governed by not only legal constraints, but also by the ethical concerns of ensuring that the patient is properly served. Considering our practices from a patient’s perspective can help optometrists understand the multiple responsibilities of clinical practice. (S Afr Optom 2010 69(2) 93-99)

A new professional paradigm: whence and whither

Medical professionalism is challenged by commercial conflicts, federal law and regulation, and a changing health care system. The profession must reaffirm its traditional role and transform into a larger social role, setting standards and preserving ethical principles in health care.

Female patients report on health care staff's disobedience of ethical principles

Earlier studies have shown a high prevalence of abuse in health care (AHC). We hypothesized that patients might easily feel abused when staff do not follow prevailing ethical principles. Therefore we developed the Violations of Ethical Principles Questionnaire (ViolEP), with 30 examples of situations in health care where four ethical principles are disobeyed (autonomy, nonmaleficence, justice, and integrity). Respondents reported whether or not they had ever experienced each of the situations, and whether or not they had perceived that event as a violation. 1. What proportion of female patients have ever experienced staff disobeying ethical principles in health care? 2. To what extent are such events perceived as violations? and 3. How well do perceived violations of ethical principles correspond to experiences of AHC? Our sample was 661 consecutive female patients at the Department of Obstetrics and Gynecology in Linköping, Sweden. They completed ViolEP and NorVold Abuse Questionnaire (NorAQ) at home and returned them by post. 20/661 (64%) women answered the ViolEP and 426/661 (64%) returned the NorAQ. The majority (73%) (306/420) had experienced staff disobeying ethical principles. More than every second woman had perceived those events as violations (68%) (209/306). The prevalence of AHC was 23%. ViolEP had good sensitivity but low specificity when we used AHC according to NorAQ as the "gold standard". The majority of the patients had experienced health care staff disobeying prevailing ethical principles. These events were not always perceived as violations. The reason for this discrepancy needs to be explored.

A Quick Guide to Ethical Theory in Healthcare: Solving Ethical Dilemmas in Nutrition Support Situations

Ethical dilemmas can be challenging for the nutrition support clinician who is accustomed to evidence-based practice. The emotional and personal nature of ethical decision making can present difficulties, and conflict can arise when people have different ethical perspectives. An understanding of ethical terms and ethical theories can be helpful in clarifying the source of this conflict. These may include prominent ethical theories such as moral relativism, utilitarianism, Kantian absolutism, Aristotle's virtue ethics and ethics of care, as well as the key ethical principles in healthcare (autonomy, beneficence, nonmaleficence, and justice). Adopting a step-by-step approach can simplify the process of resolving ethical problems.

The role of ethical principles in health care and the implications for ethical codes.

A common ethical code for everybody involved in health care is desirable, but there are important limitations to the role such a code could play. In order to understand these...

Fundamental ethical principles in health care.

In an attempt to clarify which requirements of morality are logically primary to the ethics of health care, two questions are examined: is there sufficient common ground among the medical, nursing, paramedical, chaplaincy, and social work professions to justify looking for ethical principles common to health care? Do sufficient logical grounds or consensus among health workers and the public exist to speak of "fundamental ethical principles in health care"? While respect for persons, justice, and beneficence are fundamental principles in a formal sense, how we view these principles in practice will depend on our particular culture and experience and the kinds of metaethical criteria we use for applying these principles.