Hec Forum最新文献_第5页

Responsible Decision Making for AI in Healthcare: Exploring the Role of Ethics Consultants at the Intersection of Ethics and AI. 人工智能在医疗保健中的负责任决策：探索伦理顾问在伦理和人工智能交叉中的作用。

IF 1.6 4区哲学

Hec Forum Pub Date : 2026-06-01 Epub Date: 2025-11-09 DOI: 10.1007/s10730-025-09567-4

Michael McCarthy

引用次数: 0

Evaluating Nurse Conscientious Objection: Application of a Novel Framework. 评估护士良心反对：一个新框架的应用。

IF 1.6 4区哲学

Hec Forum Pub Date : 2026-06-01 Epub Date: 2025-08-09 DOI: 10.1007/s10730-025-09556-7

Maya Zumstein-Shaha, Lucia D Wocial, Vicki D Lachman, Norah Louise Johnson, Cynda Hylton Rushton, Pamela J Grace

{"title":"Evaluating Nurse Conscientious Objection: Application of a Novel Framework.","authors":"Maya Zumstein-Shaha, Lucia D Wocial, Vicki D Lachman, Norah Louise Johnson, Cynda Hylton Rushton, Pamela J Grace","doi":"10.1007/s10730-025-09556-7","DOIUrl":"10.1007/s10730-025-09556-7","url":null,"abstract":"Certain moral beliefs and/or values about what is good or harmful can cause nurses and other healthcare professionals to object to participating in some clinical actions. Such objections are also called conscientious objections. Invocation of a conscientious objection (CO) can produce complexities in patient care and health care delivery and must be mindfully evaluated for its soundness. In this manuscript, a recently developed framework, The Ethical Evaluation of a Nurse's Conscientious Objection (EENCO), is applied to expose hidden elements and nuances in a proposed or actual CO by nurses or other healthcare professionals, thereby illuminating strategies that can lessen associated harms. The EENCO is utilized to explore two types of situations where a nurse makes a CO claim. Scenario 1 involves a nurse's reluctance to follow provider medication orders intended to relieve pain and suffering at the end-of-life. In scenario 2, nurses object to a visitation policy during the COVID-19 pandemic. Additionally, we provide a summary of the necessary elements of institutional policy to address claims of CO using the EENCO. Drawing on the EENCO, the two scenarios were analyzed for their ethical implications. This framework contributes to the exposure, scrutiny, and clarification of potentially unappreciated aspects of CO claims. Steps for developing institutional policy are identified. Application of the EENCO guides the analysis of the two scenarios. CO claims are explored more deeply, thereby revealing implications for those involved. Additionally, the EENCO provides guidance for the development of institutional CO policies.","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":" ","pages":"147-173"},"PeriodicalIF":1.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13194231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Balancing Objectivity and Humanity: Ethical Challenges and Considerations in Surgical Candidacy Decisions. 平衡客观性和人性：外科候选资格决定中的伦理挑战和考虑。

IF 1.6 4区哲学

Hec Forum Pub Date : 2026-06-01 Epub Date: 2025-08-31 DOI: 10.1007/s10730-025-09565-6

Anthony S Peterson, Bryan Pilkington

{"title":"Balancing Objectivity and Humanity: Ethical Challenges and Considerations in Surgical Candidacy Decisions.","authors":"Anthony S Peterson, Bryan Pilkington","doi":"10.1007/s10730-025-09565-6","DOIUrl":"10.1007/s10730-025-09565-6","url":null,"abstract":"An essential element of determining surgical candidacy is an accurate understanding of the risks to a given patient. While surgeons remain largely responsible for the selection of their patients, and surgeons' intuition has been shown to be a good indicator of postoperative outcomes, the recent focus in medicine towards minimizing the impact of physician bias has spurred a push towards prioritizing risk assessment tools in candidacy decisions. This has rekindled the debate surrounding what should determine surgical candidacy. Risk assessment tools are proven to be moderately to highly accurate at assessing the risk due to objective and proven risk factors, such as the impact of age or comorbidities. However, they fail to account for the humanity of both the surgeon and the patient and do not measure less easily quantifiable risk factors, such as a surgeon's comfort with a procedure or a patient's health beliefs, when determining risk. In this project, we offer an ethical analysis that highlights these less acknowledged factors. We argue that these factors need to be given greater consideration in risk assessment and surgical candidacy decisions, as they too can affect postoperative risks and outcomes.","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":" ","pages":"175-189"},"PeriodicalIF":1.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13194197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

On the Formation of Professional Identity in Clinical Ethics Consultation: Future or Illusion? 临床伦理咨询职业认同的形成：未来还是幻想？

IF 1.6 4区哲学

Hec Forum Pub Date : 2026-04-19 DOI: 10.1007/s10730-026-09590-z

Margie Hodges Shaw, Brian Childs

引用次数: 0

Community Input on NRP: Establishing Ethical Guidelines for Normothermic Regional Perfusion Through Community and Professional Engagement. 社区对NRP的投入：通过社区和专业参与建立恒温区域灌注的道德准则。

IF 1.6 4区哲学

Hec Forum Pub Date : 2026-04-12 DOI: 10.1007/s10730-026-09587-8

Jeffrey Pannekoek, Georgina Morley, Jane Jankowski

引用次数: 0

A Survey of Ethics Review Committees in New York State Hospitals: Key Findings and Lessons. 对纽约州医院伦理审查委员会的调查：主要发现和教训。

IF 1.6 4区哲学

Hec Forum Pub Date : 2026-04-12 DOI: 10.1007/s10730-026-09592-x

Nicholas R Mercado, Robert N Swidler, B Corbett Walsh, Adira Hulkower, Margie Hodges Shaw

{"title":"A Survey of Ethics Review Committees in New York State Hospitals: Key Findings and Lessons.","authors":"Nicholas R Mercado, Robert N Swidler, B Corbett Walsh, Adira Hulkower, Margie Hodges Shaw","doi":"10.1007/s10730-026-09592-x","DOIUrl":"10.1007/s10730-026-09592-x","url":null,"abstract":"New York State’s Family Health Care Decisions Act (FHCDA) governs health care decisions for patients who lack capacity and who did not decide in advance or appoint a health care agent. It also requires each hospital, nursing home, and hospice to establish an “Ethics Review Committee” (ERC) to perform certain advisory and dispute resolution functions and, in some instances, to approve or deny proposals to withdraw or withhold life-sustaining treatment. Although the ERC requirement has been in effect since 2010, not much is known about ERCs. This study involved sending a de-identified email survey to ethics professionals at New York State hospitals. Survey results found that hospitals have employed a variety of approaches to organize and operate their ERCs, that there is variability in the relationship between their ERC and other hospital ethics committees or services, and that there are differences in the capabilities of smaller or non-system hospitals as compared to larger or system hospitals. The study also found that many ERCs do not offer or require training for members, do not meet regularly, and do not have members who have ethics expertise. We suggest that ERCs could benefit by addressing those areas and others, and we offer some recommendations. Finally, we found that hospitals regard their ERCs as moderately successful in performing many of their key assigned functions, including end-of-life decision-making in cases where they have that authority.","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147663136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

From Wise Counselors to Clinical Ethicists: Historical Milestones and Their Impact on Professional Identity Formation. 从明智的咨询师到临床伦理学家：历史里程碑及其对职业认同形成的影响。

IF 1.6 4区哲学

Hec Forum Pub Date : 2026-04-10 DOI: 10.1007/s10730-026-09589-6

Anita J Tarzian

{"title":"From Wise Counselors to Clinical Ethicists: Historical Milestones and Their Impact on Professional Identity Formation.","authors":"Anita J Tarzian","doi":"10.1007/s10730-026-09589-6","DOIUrl":"10.1007/s10730-026-09589-6","url":null,"abstract":"This paper explores how historical bioethics milestones have shaped the professional identity of clinical ethicists, discussing both the benefits and challenges of professionalizing the role of the clinical ethicist by comparing how a “wise counselor,” an ethics consultant, and a clinical ethicist provide healthcare ethics guidance. I examine the evolution of clinical ethics as a sub-category of bioethics, tracing its origins and key milestones in its development toward professionalization. These include the American Society for Bioethics and Humanities’ (ASBH) Core Competencies for Health Care Ethics Consultation reports, ASBH’s Code of Ethics and Professional Responsibilities for Healthcare Ethics Consultants, Fox et al.’s national surveys of healthcare ethics consultation in the United States, and the emergence of the Healthcare Ethics Consultant Certification (HEC-C) program. Practicing as a clinical ethicist requires mastery of a wide scope of knowledge, skills, and attitudes reflected in each stage of the field’s development. Reflecting on this history may yield clues for how clinical ethicists position themselves for the next phase of the field’s evolution.","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Hub-and-Spoke Model for Organizing an Ethics Program. 组织道德项目的中心辐射式模型。

IF 1.6 4区哲学

Hec Forum Pub Date : 2026-04-10 DOI: 10.1007/s10730-026-09591-y

Jürgen Wallner

引用次数: 0

Embedding Clinical Ethics: A Qualitative Study of the Adoption, Implementation, and Everyday Functioning of Clinical Ethics Committees in Germany, Switzerland, and Austria. 嵌入临床伦理：对德国、瑞士和奥地利临床伦理委员会的采用、实施和日常运作的定性研究。

IF 1.6 4区哲学

Hec Forum Pub Date : 2026-04-01 DOI: 10.1007/s10730-026-09588-7

Gilles Bernard, Michael Fischer

{"title":"Embedding Clinical Ethics: A Qualitative Study of the Adoption, Implementation, and Everyday Functioning of Clinical Ethics Committees in Germany, Switzerland, and Austria.","authors":"Gilles Bernard, Michael Fischer","doi":"10.1007/s10730-026-09588-7","DOIUrl":"10.1007/s10730-026-09588-7","url":null,"abstract":"Clinical ethics committees support ethical decision-making in healthcare. In the DACH region (Germany, Austria, Switzerland), their adoption is growing, but factors shaping implementation and daily functioning remain underexplored. Development has been uneven, and little is known about what drives it. This qualitative study examined influences on committee adoption, implementation, and routine practice. Semi structured expert interviews were conducted with committee representatives and researchers, then analysed using thematic qualitative text analysis in MAXQDA, identifying six key themes. The adoption is driven by bottom-up and top-down initiatives, external pioneers, societal debates, certification demands, and resources. Efficient implementation relied on leadership, protected time and funding, committee member role clarity, and visibility through early activities. Everyday functioning depended on member motivation, clinician acceptance, staffing, training, networking, and regulatory and cultural factors. Evaluation of their activities was frequently emphasized but often constrained by limited resources. Legal and regulatory requirements were also debated: mandates could promote establishment but risk tokenism, making softer mechanisms preferable. Future directions emphasized professionalization, billing options, care integration, organizational models, and systematic evaluation. Sustainable, high-quality committee functioning requires coordinated action across policy and institutional levels, alongside clinician engagement and evaluation capacity. These empirically grounded insights provide practical strategies for managers and policymakers to strengthen clinical ethics infrastructure in the DACH context.","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rural Georgians' Perspectives on Organ Donation. 格鲁吉亚农村人对器官捐赠的看法。

IF 1.2 4区哲学

Hec Forum Pub Date : 2026-03-29 DOI: 10.1007/s10730-026-09586-9

Isait E Alvarado, Logan Reid, Caroline Anglim, Brian Childs

{"title":"Rural Georgians' Perspectives on Organ Donation.","authors":"Isait E Alvarado, Logan Reid, Caroline Anglim, Brian Childs","doi":"10.1007/s10730-026-09586-9","DOIUrl":"https://doi.org/10.1007/s10730-026-09586-9","url":null,"abstract":"According to the databases utilized by the organ procurement organization, whose donation service area is Georgia (LifeLink Foundation of Georgia), Irwin, Ben Hill, and Coffee counties reported disproportionately low organ donation rates relative to other counties within the state of Georgia. The three counties have an aggregate population of about 70,000 citizens, and there have been roughly 50 cases or less of organ donation within the most recent decade (Data USA, 2024, https://datausa.io/ ). This is a qualitative study of rural Georgians' perspectives on organ donation. This study identifies cultural and religious beliefs that influence perspectives and explores lines of rationale that people demonstrate regarding hesitancy to organ donation in these communities. 21 one-on-one interviews were conducted with the participants. The interviews were recorded and transcribed. Data analysis, adopted from A Step-By-Step Guide to Qualitative Data Coding, involved manual coding of interview transcripts to gather insights and identify trends with intent to establish themes (A step-by-step guide to qualitative data coding, Taylor & Francis Group, 2019). After analyzing the data, four themes were identified: (1) little knowledge and promotion suggestions, (2) religious ambiguity, (3) overall positivity despite skepticism and misconceptions about the donation process, and (4) limited awareness of organ donation.","PeriodicalId":46160,"journal":{"name":"Hec Forum","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0