Bioethical Knowledge Research Articles

Level of knowledge of bioethics in health sciences students

Level of knowledge of bioethics in health sciences students

Impairments of Human Dignity at the End of Life Quantitatively Assessed by Health Care Professionals: A Pilot Study From Germany.

Empirical investigations on health care professionals' (HCPs) perception of dignity have already spotted common themes in preserving dignity in end-of-life care. However, heterogenic assessment results of varying HCP groups exist. This pilot study wants to provide further evidence on HCPs' rating of dignity-impairing aspects based on a patient-centered concept, especially regarding different underlying job profiles and other professional characteristics. In a quantitative study design, the rating of dignity-impairing factors in end-of-life care via an adapted version of the Patient Dignity Inventory (aPDI) was assessed. Participants of the relevant professional groups were recruited via convenience sampling from a region of Germany. From the final sample of participants, 229 questionnaires were analyzed. The overall importance of each dignity-impairing aspect in end-of-life care was considered to be very high by all different HCP groups. Nonetheless, ratings differed between professions: nursing staff had the highest ratings of importance compared to both physicians and individuals with multiple occupations. Participants with previous knowledge in bioethics also rated some aspects as more important compared to those without this feature. With the findings of this investigation, an insight of how professionals rate impairments of dignity at the end of life based on a patient-centered concept is given. Thus, a link between empirical research and medical ethics is added. Potential normative implications for HCPs in practice of a dignified care can be derived, consisting of actively addressing social topics as well as further stressing ethics as a fundamental subject in the training and continuing education.

Assessment of the understanding and awareness of bioethics among healthcare professionals in all public and private hospitals of Haripur district, Pakistan: a multicentre cross-sectional study

ObjectiveTo assess the level of bioethics awareness among healthcare professionals in Pakistan, focusing on the associations with sociodemographic characteristics, training and teaching of ethics, medical ethics practice and specific ethical...

ROL DOCENTE DE LOS COMITÉS DE ÉTICA ASISTENCIAL Y LOS COMITÉS ÉTICO CIENTÍFICOS

The Health Care Ethics Committees and the Scientific Ethics Committees are mainly respon­sible for advising clinicians in making complex decisions, and for reviewing, correcting and approving scientific work projects, respectively. In general, these committees devote little time to teaching and dissemination, areas in which, by sharing their experience and knowledge, they can contribute enormously to generating a culture of ethical reflection, both in the health care setting and in teaching and research. This article examines how both types of committees can improve knowledge and understanding of ethics and bioethics in their institutions, in university teaching and in the community. It begins with a brief review of the milestones that led to their emergence. Subsequently, its functions are reviewed, both from a theoretical point of view and in legislation. Finally, it is proposed in which areas and in what way Health Care Ethics Committees and Scientific Ethics Committees can develop a teaching and community outreach function, promoting values such as respect, care, altruism, rigor, honesty and justice.

Understanding, being, and doing of bioethics; a state-level cross-sectional study of knowledge, attitude, and practice among healthcare professionals.

The field of bioethics examines the moral and ethical dilemmas that arise in the biological sciences, healthcare, and medical practices. There has been a rise in medical negligence cases, complaints against healthcare workers, and public dissatisfaction with healthcare professionals, according to reports from the Indian Medical Council and other healthcare associations. We intend to assess the level of knowledge, attitude, and practice of bioethics among the registered healthcare professionals (HCPs) of Maharashtra, India. A State-level online survey was conducted among the registered HCPs (n = 2143) casing all five regions of the Maharashtra state using a pre-tested self-administered questionnaire. The responses were expressed as mean, and proportions with their standard deviation and 95% CI respectively. Binary logistic regression and a multivariate logistic model were used to determine factors associated with knowledge, attitude, and practice of bioethics. Of the 2143 registered HCPs in Maharashtra included in this study, most of them (65.2%) had adequate knowledge of bioethics. Adequate knowledge was associated with lower age, profession (nurses and dentists), employment in the private sector, HCPS at Marathwada and Pune, and higher educational attainment. About 3 in 5 HCPs (59.4%) had a favorable attitude towards the ethical practice of bioethics, and was associated with profession, place of work, region of practice, and work experience. The distribution of unethical bioethics practices among 10 items was proportionally high, and only 34.4% reported good/fair practice. The common unethical practices in the state were allowing patients to be examined by interns, and not informing them about professional misconduct to the regulatory bodies. Most HCPs had adequate knowledge of bioethics, which is encouraging and would favor the laying foundation for forming a good bioethics framework. Only 3/5 HCPs demonstrated a favorable attitude, and the observed unethical practice is alarmingly common. A serious consideration to evaluate the compliance level of bioethics practice periodically and measures to educate, sensitize, and train bioethics among HCPs in Maharashtra is warranted.

Moral sensitivity and academic ethical awareness of nursing and medical students: A cross-sectional survey.

Moral sensitivity and academic integrity discernment hold paramount importance for healthcare professionals. Owing to distinct undergraduate educational backgrounds, nurses and physicians may exhibit divergent moral perspectives, academic integrity cognisance, and moral sensitivity within clinical environments. A limited number of studies have investigated the disparities and congruencies pertaining to moral sensitivity and academic ethical awareness among nursing and medical students. The study compares moral sensitivity and academic ethical awareness of undergraduate nursing and medical students with and without clinical exposure. A self-administered cross-sectional survey conducted from January to February 2022 was used to collect data from a medical school in Hong Kong. A total of 545 respondents, including 137 nursing students and 408 medical students, completed the questionnaire. Ethics approval of the study was obtained. Written consent was waived to maintain anonymity because completing the questionnaire was considered implied consent. Both groups of undergraduates demonstrated a high level of bioethics knowledge. In terms of academic integrity, medical students were found to have a less concerned attitude towards punctuality, attendance, and skipping classes. Regarding moral sensitivity, senior medical students with clinical experience put less emphasis on decision-making involving patient participation, while senior nursing students were more hesitant in withholding treatment for incompetent patients who refused treatment. Both nursing and medical students showed decreased moral sensitivity in the 'conflicts' domain with increased clinical exposure. Study findings contribute to the discussion comparing the ethical attitudes of nursing and medical students. More effort should be made in nursing and medical education to promote practices in line with high academic integrity and to develop the ability to be morally sensitive in professional settings.

The Impact of Clinical Ethics Consultations on Physicians in aLatin American Context.

Clinical bioethics plays a significant role in hospital settings through bioethics consultations, which focus on providing ongoing assistance in complex situations within the doctor-patient dynamic. These consultations entail regular interaction between physicians and clinical bioethicists. This situation prompts an exploration into how bioethics consultations affect physicians. The current research aims to understand the influence of bioethics consultations on physicians' bioethical knowledge by analyzing the lexical content in their patients' medical records. Medical records are a synthesis carried out by physicians, often reflecting collaborative efforts, and capturing verbal statements indicative of thought processes suggestive of learning. The study is a sequential mixed-methods design with a retrospective descriptive approach, comparing medical records from the early years of the Department of Humanism and Bioethics' operation (2013-2015) to the more recent ones (2019). Technical bioethical terminology such as "therapeutic effort limitation," "futility," "beneficence," and "respect for autonomy" is more prevalent in recent medical records. This trend may stem from the positive impact of bioethics consultations conducted by the Department, with haptic communication serving as a particularly effective form of interaction with others during experiences of moral distress. This appears to be characteristic of cultures like those in Latin America.

Abstract A005: The development of a bioethically sensitive education video: Addressing the barriers to African Americans’ and Hispanics’ participation in clinical and genomic research through digital animation

Abstract Introduction: Research advances on effective methods to prevent, diagnose and treat cancer continue to emerge through clinical and genomic research. To ensure the results from these research studies help those who need it most, a diverse population needs to enroll. Despite guidance from authorities, such as the National Institutes of Health, most clinical trial and genomic research participants identify as White. At the participant level, mistrust of research, unawareness of research opportunities and gaps in bioethical knowledge about clinical trials and genomic research remain proven barriers to participating, especially among African Americans (AA) and Hispanics. With the development and access to technology, digital delivery of salient and tailored health education may provide innovative pathways to increase representation of AA and Hispanics in research. Methods: Members from the NCI-funded Partnerships to Advance Cancer Health Equity (PACHE) including experts from the community, healthcare, biomedical research and public health, such as oncologists, cancer geneticists, behavioral scientists and bioethicists collaborated on all phases. A design lab with experience synthesizing complex health messages into brief animations was contracted. The goal was to utilize existing educational resources from the National Cancer Institute and the National Human Genome Research Institute to create a tailored message to address AA's and 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 animated video. Results: Development of the video consisted of six iterative phases: 1) writing sessions; 2) storyboarding; 3) animating; 4) screening/revisions; 5) acceptability testing; 6) finalization. In the last two steps, the video was presented to family members of cancer patients, cancer survivors and community members who provided quantitative and qualitative feedback which informed further edits. The final animated video is approximately five minutes in length and covers several topics including the goal of clinical research, disparities in clinical trials and genomic research participation, genomic research regulations and the purpose of a biobank. Supporting imagery to emphasize specific concepts, such as racial disparities in research, was dispersed throughout the video. A voiceover emphasized key bioethical concepts, including how research participation is safe and voluntary. When possible, characters were designed to resemble the targeted viewing audience. Discussion: 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. Future research will evaluate the efficacy of the video through a multi-level framework in real-world settings. Citation Format: Victoria Churchill, Yu-Mei Schoenberger, Vivian L Carter, Windy Dean-Colomb, Roland Matthews, Desiree Rivers, Stephen O Sodeke, Jamirah Chevrin, Brian Rivers. The development of a bioethically sensitive education video: Addressing the barriers to African Americans’ and Hispanics’ participation in clinical and genomic research through digital animation [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A005.

COVID-19: Falling Apart and Bouncing Back. A Collective Autoethnography Focused on Bioethics Education

The COVID-19 pandemic disrupted academic life worldwide for students as well as educators. The purpose of this study is to shed light on the collective adversity experienced by international medical students and bioethics educators caused by the COVID-19 pandemic in relation to both personal and academic life. The authors wrote their subjective memoirs and then analyzed them using a collective autoethnography method in order to find the similarities and differences between their experiences. The results reveal some consistent patterns in experience that are captured in two metaphors: Falling apart and Bouncing back. “Falling apart” involves the breakdown of daily lives during the initial stages of the pandemic, shown through subjective quotes contextualized through the authors’ commentary. The consensus is that returning home and the transition to remote education were the two main reasons for the breakdown. “Bouncing back” encompasses the authors’ recovery after the initial breakdown, achieved by acquiring new information about the virus, discovering how to continue their hobbies at home, such as working out or dancing, and learning to adjust exam expectations. At the educational level, the bioethics course, which guided students through the ethical dilemmas of the pandemic, played an important role in the recovery/bouncing back process. For that reason, we report on how it was to learn about and teach this subject during the pandemic, and how bioethics knowledge was applied for better understanding and coping with some of the moral dilemmas related to the pandemic. The study testifies to the importance of bioethics education during a pandemic and explains how this can contribute to shaping the moral resilience of future medical practitioners.

Commentary on "Circumcision".

This commentary draws upon the author's experience in bioethics and as a physician, ordained Rabbi, and certified Mohel (a Jewish professional qualified to perform infant male circumcisions (MC)). People's identity and adherence to a religious belief are frequently cited reasons for deciding whether to circumcise their male children. For Jewish and Muslim males, circumcision is considered essential. In this commentary, the author uses his medical, religious, and bioethical knowledge, expertise, and experience to address common arguments used in opposing nontherapeutic male circumcision of minors. In these narratives, half of the parents agreed with circumcision, and half did not. The parents against circumcision cite human rights violations, security, privacy, and bodily integrity issues and refer to circumcision as genital mutilation, while those who agree argue that circumcision should be done for religious reasons to prevent health issues, promote hygiene and cleanness, avoid cancer, or for later sexual enjoyment. After evaluating the evidence, the author states that parents should be free to either consent or decline MC for a son. Though a reoccurring theme in these narratives was for mothers to leave the circumcision decision up to their male partners, the author concludes that women have considerable power regarding the decision.

Knowledge and perception of bioethics among biomedical researchers in Osun State, Nigeria

This study investigated the knowledge and perceptions of bioethics among biomedical researchers in Osun State, Nigeria using a semi-structured self-administered questionnaire during a capacity workshop in November 2020. Demographic data, and attendee’ awareness, knowledge, and perception on bioethics and need for ethical approvals for biomedical research were collated. Data was analyzed using descriptive statistics and expressed as frequencies and percentages. A total of 153 biomedical researchers comprising (58%) males, and (42%) females participated in this study. Majority of the participants (60.8%) hold academic positions and about one-third of the population were graduate students (30.1%). Awareness on bioethics was high (91.5%), and more common in schools (61.4%), with majority of the participants (77.1%) describing it as a field that addresses the social and legal issues arising from medicine and life sciences (p<0.05). However, there were considerable gaps in knowledge among participants in the students and academia category, with about 16% of participants considering none or only part of the principles while about 10% felt they could obtain ethical permits while research is ongoing or completed and only 13.7% affirmed that all biomedical related researches require ethical approval. This finding calls for the incorporation of bioethics module into the curriculum of graduate students. The use of online resources, short courses, workshops and seminars can also be explored for re-enforcing training even among non-school going researchers and professionals.

Implicações bioéticas para o desenvolvimento rural sustentável

Considering the advances and technologies of conventional food production and the relationships already evidenced with devastating consequences for human health and the environment, this article brings discussions, through a bibliographic review, on the interdisciplinary genesis of bioethics and the discourse of authors of global environmental bioethics and sustainability: Van Renssealer Potter, Raquel Carson, Lutzemberg, Moltmann, Leonardo Boff and Jaime Breilh. The knowledge of bioethics within sustainable rural development, mainly related to the issue of pesticides is necessary when thinking about interdisciplinary environmental and health education. In addition to anato-physiological capacities, the human being is also a social y cultural being, with values and, equally, an environmental being, where the environment and the activities that exercises are totally connected to his health and quality of life.

The relationship between normative and empirical elements in bioethical reasoning

The article examines the internal structure of bioethics in terms of the relationship between its normative and empirical elements. It is shown that bioethical research is subject to the epistemological specificity that is characteristic of applied ethics in general: there is a certain difficulty in the theoretical representation of the transition from the analysis of empirical data to normative conclusions. It is suggested that W.R. Potter's initial characterisation of bioethics as a "bridge" between facts and values needs to be clarified and supplemented with information about the logical and epistemological mechanisms that enable the transition from facts to values, from empirical data to normative findings, and from the real to the proper. The key objective of the research presented in this article is to identify (changing at different stages of bioethics development) the relationship between normative and empirical elements of bioethical knowledge by analysing the structure of bioethical reasoning. Both "principled" and "empirically oriented" models of bioethical reasoning (including precedent conclusions, conclusions by analogy, etc.) are analysed. The significance of the phenomenon of the "empirical turn" in bioethics for the development and transformation of its epistemic structure and changes in the standards for evaluating the results of reasoning is comprehended. The interrelation of the specifics of transitions between empirical and normative contexts of bioethical knowledge and the interdisciplinary nature of bioethical research is highlighted. It demonstrates the importance of addressing the issue of the relationship between normative and empirical elements of bioethical knowledge for the justification of bioethics and the formation of ideas about its position in the system of knowledge.

Professionalism, Ethics, and Realism of Television Medical Dramas as Perceived by Saudi Medical Students.

Since their debut, medical dramas have been popular, particularly among medical students. This study examined how much time medical students spend watching medical TV shows and their impressions of the shows' professionalism, ethics, and realism. A survey on medical students' medical drama viewing behavior and perceptions with regard to bioethics was given to 341 first- to fifth-year undergraduate medical students at a university in Al Majmaah, Saudi Arabia. The poll gathered demographic information, TV medical drama watching habits, bioethical and professional concerns in medical dramas, and the sources of bioethical knowledge. The most popular medical dramas were The Good Doctor, Grey's Anatomy, and House M.D. Compared with English-language television medical dramas, Arabic ones were less popular. Ninety-one percent of students watched television alone. There was no statistically significant difference in respondents' perceptions of ethics accuracy based on year of study, gender, or whether they discussed it with friends. In comparison to students who had not seen any medical dramas, those who had were more inclined to view them as a credible source of ethical advice (P-value .04). There is a high interest in medical programs among medical students, and these programs can be used to teach them about the ethical aspects of practicing medicine.

Bioethical Knowledge and Attitudes Among Dental and Medical Students in the Medical Faculty, University of Prishtina

The importance of bioethics as a formal subject has been recognized globally. The purpose of this study was to analyze undergraduate medical and dental students’ knowledge, practice and attitudes regarding bioethical questions through a questionnaire. This cross-sectional study was conducted among students from the Medical Faculty who were in their first or fourth year of education. There were no differences in bioethics awareness between direction (general medicine [GM] or dentistry) or years of study among 301 GM and dental students. In this research, GM and dental students, in general, indicated a positive attitude and knowledge of bioethics.

Implementation of medical research module and the effect to medical students’ knowledge and perceptions

<span lang="EN-US">Research activity is one of the requirements for medical students in order to finish their study. Therefore, it needs to examine the knowledge and perceptions of medical students about medical research. The research design was an experimental one-group pretest-posttest design, involving 86 medical students, with the statistical tests using the Wilcoxon Signed-Rank Test. After the module implementation, the students’ knowledge about research had improved in the concept of theoretical basis, the concept of research methodology, and the biostatistics methods. However, there was no improvement in bioethical knowledge. Close relations between the result of pre- and post-research modules implementation were shown in the knowledge about theoretical basis, about research methodology, and the perception of workloads in college have (p<α). There were significant changes in knowledge (Z=-2.867, p=0.004) and perceptions (Z=-1.964, p=0.050) of the medical students pre- and post-research module. Giving research modules early, along with social and academic support for medical students, would improve their knowledge and positive perceptions towards research.</span>

The outcomes of a mobile just-in-time-learning intervention for teaching bioethics in Pakistan

IntroductionThe study aimed to test the effectiveness and the feasibility of a mobile just-in-time-learning (m-JiTL) approach for teaching bioethics at a university in Pakistan. Over four months, a mobile app (EthAKUL) was used to enhance ethical reasoning among practising nurses, trainee physicians, and medical and nursing students utilising the m-JiTL approach. Participants used EthAKUL to access bioethics modules and participate in asynchronous discussions.MethodsA mixed methods design was adopted. Pre- and post-knowledge tests were used to assess changes in participants' knowledge of bioethics concepts, while pre- and post-surveys were used to assess changes in participants' attitudes towards m-learning. After the intervention, focus group discussions with the participants were held. Analysis of the discussion posts and meeting notes was conducted.ResultsThe learners had a favourable attitude toward using mobile devices for learning purposes at the start of the intervention, and the score remained positive afterwards. Bioethics knowledge test scores improved at the end of the intervention, with medical students experiencing the greatest improvement. However, because of the high drop-out rate and lack of participation after the initial phase, it is unclear whether the increase in score or positive attitude is the result of the intervention, making it difficult to draw firm conclusions about the intervention's success.ConclusionsEthAKUL is the first of its kind app for teaching bioethics, and the study has offered important insights into adopting new pedagogies and technologies for bioethics teaching. It has also identified issues with the design of the app and m-JiTL pedagogy that must be addressed before curriculum-wide adoption.

Diretivas antecipadas de vontade: amparo bioético às questões éticas em saúde

Abstract This is an exploratory, cross-sectional study with a quantitative approach, with the participation of 143 physicians and nurses. An electronic questionnaire was applied on an online platform to analyze the current context of implementation of advance directives of will in Brazil from the perception of the participants. The results showed that professionals with training in palliative care have greater knowledge of advance directives (p<0.05) and feel easier to accept and implement them (p<0.001). Among those who answered that they were afraid to apply the advance directives (n=27), 15 reported that this concern is related to legal issues, and four to ethical issues. We conclude that knowing what the directives are makes the process of deliberation with the patient simpler, and knowledge in bioethics is one of the pillars to support the decision of professionals when choosing the best conduct to be adopted.

Ética médica e bioética entre estudantes de medicina

Abstract Knowledge of medical ethics and bioethics are fundamental for the correct performance of the medical professional. This study sought to understand and evaluate discussions about medical ethics and bioethics among students of a medical course via the application of a questionnaire. Most (89%) students consider the theme extremely important. For only 9.2% the approach to the theme was great, for 34.5% it was good, 34.5% considered it regular and 21.8% bad. They claim that the subject is best approached in practical activities or in discussions in small groups. This study concludes that the theme of medical ethics and bioethics was considered of high importance by almost all participants, and it is necessary to identify the parameters considered appropriate and to specify how the theme is understood by students to have an adequate approach in medical education.

Bioethics Training: Report on the Experience of a Medical Bioethics’ Scholar in a Tertiary Referral Hospital in a Lowand Middle-Income Country

Skills in biomedical ethics are limited in the African health care systems. This significantly affects the bioethics discourse in the medical practice. The main reason for the paucity in knowledge and skills in bioethics is minimal or no training at all imparted to healthcare professionals. Where there is training, it is not well-structured like other courses in the training institutions. This report summarizes the status of bioethics training and outlines the implementation, processes, outcome and future outlook of a bioethics teaching project for masters in medicine residents (students) in a tertiary referral hospital in Africa. This project was part of postgraduate studies in biomedical ethics by a practicing physician. It entailed teaching bioethics to first year master’s in medicine residents (students). The teachings occurred in the author’s affiliated institution monthly for six-months. The topics covered were: general introduction to bioethics, ethical issues at end-of-life (EoL), informed consent, basics of research ethics, plagiarism and doctor-pharma interaction. These topics were selected due to their relevance to the residents in their practice and because they needed to undertake research studies to graduate from the masters training program. In addition, these basic bioethics training provided the residents with the foundation to develop knowledge geared towards improving skills in analyzing diverse areas in the contemporary bioethics’ environment such as end-of-life care (EoLC), human research ethics, doctor-pharmaceutical relationships while looking at them within the context of political, cultural, socio-economic, and environmental determinants.