Suchergebnisse

"In Europe, Moral Case Deliberation (MCD) has been well-known and established as a form of Clinical Ethics Support (CES) and implemented in many international (health care) institutions. Since 2007 Amsterdam UMC organizes training for professionals to become a facilitator of MCD. To support and asses the development of those future facilitators MCD, an instrument has been developed which can be used by both trainees and trainers. The instrument consists of a self-reflection form and an observation form. Both forms are almost identical and contain a part of open questions reflecting upon the personal learning goals of the trainee and a part of 56 closed questions. The part of closed questions contains concrete descriptions of preferred skills and attitude of the MCD facilitator trainee, related to MCD in general and the specific steps of the Dilemma method and the Socratic Dialogue in particular. Special attention is being paid to concrete actions for fostering a dialogue and deepening the moral inquiry. The instrument can also be used by trained and more experienced facilitators of MCD to reflect upon their acquired skills and attitude, and indirectly on the quality of CES they provide. In this presentation we will present the instrument and share our experiences in using the two forms in order to train and assess (the quality of) facilitators of MCD. Furthermore, we will present preliminary results of the analysis of more than 1200 forms collected in the past decade from trainings on national and international level. "

"The areas of Research Ethics and Research Integrity (RE+RI) are rapidly evolving. Guidelines, standards, and laws have been drafted in many countries, regions and institutions. However, the regulatory proliferation does not necessarily yield clear guidance for practice: researchers often lack up-to-date and easily accessible information and guidance on how to apply principles and norms. The same is true for RE+RI evaluation committees, who lack easy access to case studies. The Embassy of Good Science is an online initiative to address these problems. The Semantic MediaWiki platform brings together, and makes smart connections between, relevant guidelines and regulations, cases and scenarios, and teaching materials. The platform provides practical information about how to apply norms and principles in every day practice and how to teach about them. For example, The Embassy contains cases and scenarios on researchers' day-to-day dilemmas, a discussion forum where researchers can share experiences, and easily adaptable teaching resources. Developed in consultation with stakeholders, the Embassy is managed by the European funded EnTIRE project. The initial content has been gathered via systematic reviews and is continually added to and updated by users. In the long-term, The Embassy will be community-owned and sustainable. The Embassy primarily supports researchers and RE+RI committee members. The platform also presents the opportunity to compare RE+RI principles, norms and practices worldwide, facilitating mutual learning and making the diversity of the RE+RI regulatory framework apparent. In this session, we will describe and demonstrate The Embassy's value for practice, education and policy. "

"Since the first successful application of the gene editing method based on the CRISPR/Cas-system, the technology has demonstrated great potential but also sparked a series of ethical concerns. Some of the issues are already known from earlier gene editing debates. However, the possibility of CRISPR to target genes with high accuracy and the easy application that allows a biohacker to experiment with a simple toolkit ordered online have introduced new ethical challenges. Further, thanks to preprint servers such as bioRxiv, biomedical research results are more and more accessible with little delay after an experiment was conducted. This enables researchers all over the world to participate and conduct their own experiments, making it a global endeavour. Not only does this make it difficult to monitor and regulate the technology but also speeds up the technological development significantly.CRISPR is only one of many examples of recent advancements with potentially high consequences for society at large. We think it is therefore paramount to identify new issues, understand their nature and assess their impact in a timely manner. In this paper, we propose the integration of digital methods into the toolbox of modern empirical bioethics and demonstrate their potential with two examples: We used 1) crawling and network analysis for hypothesis building, and 2) sentiment analysis to assess the public's attitudes towards CRISPR on Twitter over a six and a half years period. "

"The development and use of home monitoring or remote patient monitoring has rapidly evolved due to scaling down of face-to-face patient care during the corona pandemic. Home monitoring systems for Covid-19 as well as for other conditions are proliferating. One of the stated goals of home monitoring systems is to promote patient empowerment. However, this concept is hardly well defined and often used in a rhetorical way. In this presentation, we will discuss the findings of our empirical study into the views of patients, healthcare professionals and policy makers regarding patient empowerment. We report on the results of two case studies of home monitoring systems in the Netherlands implemented during the corona crisis, in which we study, first, what patients, healthcare professionals and policy makers understand patient empowerment to be, and second, whether they think patient empowerment is actually promoted in these contexts. Finally, we will describe different interpretations or degrees of patient empowerment – compliant, concordant, and collaborative - and normatively argue for home monitoring systems that promote optimal patient empowerment. "

"A comparative corpus-based study of European Portuguese discourse markers bom and bem and French bon and bien. According to many authors, Discourse Markers (DM) serve as signals or triggers guiding the process of interpretation (Fraser 2006, Aijmer 2013, Maschler and Schiffrin 2015, among many others), thus having a more procedural than conceptual meaning. This study aims to investigate and specify the structural positions and the semantic-discursive functions of the DMs 'bem' and 'bom' in European Portuguese and of 'bon' and 'bien' in French, then to compare these positions and functions. The study relies on two European oral corpora for each language. The methodology is quantitative and qualitative. The analysis focuses primarily on the structural and modal levels, following mainly Oliveira and Silva's (2020) proposal for the study of 'bem' and 'bom' and the proposal of Peltier and Ranson (2020) for 'bon'. Results show that isolated DM 'bom' and 'bem' are equally frequent in the C-ORAL-ROM and that 'bem' is much more frequent than 'bom' in the local corpus Fala Bracarense. They also show that 'bien' is very rare as an isolated DM in both French corpora, while 'bon' is much more frequent than 'bom', 'bem' and 'bien'. Regarding structural positions, these DMs occur mainly as turn medial, while structural and modal functions are more differentiated depending on the DM, the corpus and the language. Thus, the study shows that although these European French and Portuguese DMs share the same etymology, they differ in usage. Keywords: Discourse markers, European Portuguese, French, oral corpora, semantic-discursive functions"

"Tobacco smoking is especially harmful for women because, in addition to its effects on mortality and morbidity, it negatively impacts pregnancy, reproductive, and health of the offspring. Data from our work in Romania revealed that pregnant tobacco smokers are seeking information and clinical advice related to e-cigarette use as a tobacco cessation approach. E-cigarette use increased rapidly in the recent years in the US and in other countries, including LMICs. The tobacco control field is deeply divided on how to respond to the increase in e-cigarette use. Additional evidence on the ethical issues related to e-cigarette use and tobacco cessation will inform our mHealth and other pregnancy tobacco cessation interventions and will guide future tobacco control policy direction. The objective of this study is to identify ethical concerns and associated attitudes and perceptions related to e-cigarette use for tobacco cessation during pregnancy among pregnant smokers, their life partners, medical professionals, and other stakeholders. We will interview (N=20) and conduct two focus groups with women who smoke (one focus group, N=10) and women who quit during pregnancy (one focus group, N=10); interview life partners (N=10) of such women; interview ObGyn physicians (N=10) and nurses (N=10); and interview (N=10) and conduct one focus group (N=10) with perinatal educators. Other relevant stakeholders will be also interviewed including the leadership of 2035 Tobacco Free Romania, the national Stop Smoking program, the Pure Air consortium, the Romanian Pneumology Society, the SAMAS NGO focused on maternal and child health and rights, and others. With respect to expected outcomes, the proposed application is anticipated to advance understanding of the smokers' and other stakeholders' ethical concerns and associated attitudes and perceptions related to e-cigarettes use for tobacco smoking cessation. The in-depth new knowledge will have a positive impact on the cessation of prenatal and postnatal tobacco smoking and will inform future tobacco control policy directions. Results will be available and will be presented at the time of the conference. This work is based on research partly funded through six NIH-funded projects (grant no. K01TW009654, R21TW010896, 5R21TW010896-02S1, 5R21TW010896-02S2, 1R21HD103039-0, 1R25TW010518-01A1). "

"Introduction. Medical practice is almost constantly bending to new technologies, and in recent years, the health care system has been increasingly dominated by advances in information technology. Its use offers many advantages, but it also has its own risks. Material and method. The authors conducted a literature review to see to what extent the accessibility and effective use of information technology, i.e. electronic health records (EHR) influence risk of malpractice. Results. The literature refers both to how EHR use can prevent malpractice claims, and how it can increase their number. Thus, EHR can prevent medical errors and associated complaints by: instant access to complete patient information (including laboratory and imaging results); improving communication between medical team members; reducing drug errors (e.g. drug interactions, allergic reactions); prompt request for further investigations. However, the misuse of EHR can create new problems: inadequate training with errors from implementation and accommodation; automatic or unexpected deletion of the recommended medication; the temptation to use the information obtained previously and the circumvention of the stage of obtaining a new medical history or the temptation to copy and paste the information from the previous consultations to the current consultation - which will lead to the perpetuation of errors and omissions from the previous consultations; increased risk of privacy and confidentiality breach. Likewise, certain facilities that these systems allow may be ambivalent, and may both reduce or increase the risk of complaints, depending on how they are used: communication between doctor and patient through messages, including updating prescriptions and reporting symptoms that require prompt evaluation but at the same time, delay in response may dissatisfy the patient. Conclusions. The implementation of EHR brings many advantages, both for the patient and for the medical staff in terms of accessing information, facilitating communication and carrying out treatment plans, but the medical staff must be constantly aware of the risks involved, especially related to their proper use. "

"Background. Vulnerability is a key concept in traditional – as well as contemporary – bioethics and medical ethics (Ten Have 2015, 2016). Within this literature, the concept of vulnerability is mostly defined in relation to autonomy: vulnerability refers to conditions of impaired and/or diminished autonomy (Belmont Report 1979; CIOMS 1991, 1993, 2002; WMA 2000, 2008; Bracken-Roche et al. 2017). Historically, vulnerability has been associated with several categories of agents, amongst which the elderly are paramount. However, no clear and unique conceptualization of vulnerability, when referred to the ageing population, is currently present – especially in domains other than research ethics: some refer to physiological degradation as a defining tenet, some others appeal to autonomy impairment, some others point to loneliness and isolation (Kahana et al. 1995; Slaets 2006; Dodds 2007; Andrew et al. 2008: Sternberg et al. 2011; Clegg et al. 2013). To fill this gap, we examined the meaning, foundations, and uses of vulnerability as ethical concept in the literature of aged care. Method. Using PRISMA procedure, we conducted a systematic review of argument-based ethics publications in 4 major databases (Pubmed, Embase, Web of Science, and Philosopher's Index) of biomedical, philosophy, bioethical, and anthropological literature that focused on vulnerability in aged care. 5,735 results were obtained. Titles and abstracts were all screened. We are now in the process of full articles screening. All includes articles will then be critically analyzed. The results of this analysis process as well as a critical reflection on the results will be presented at the EACME conference. "