BMC Medical Ethics最新文献

{"title":"Contribution and legacy: a qualitative study of older people's attitudes about sharing their routinely collected health data for research purposes in New Zealand.","authors":"Engelina Groenewald, Jasmine Appleton, Brendan Hallam, Cristian Gonzalez-Prieto, Susan Yates, Daniel Wilson, Gillian Dobbie, Rosie Dobson, Sarah Cullum","doi":"10.1186/s12910-025-01212-6","DOIUrl":"https://doi.org/10.1186/s12910-025-01212-6","url":null,"abstract":"<p><strong>Background: </strong>Older adults, especially those with dementia, are often excluded from health research due to physical and medical comorbidities, and the assumption that those with cognitive impairment won't be able to consent. Using routinely collected data for research purposes is a way to include older people in research, and therefore the benefits of research. However, very little research has been done to examine the attitudes of older people towards sharing their routinely collected health data for research purposes.</p><p><strong>Method: </strong>Twenty-eight semi-structured interviews were conducted with older health service users in the Counties Manukau health district of Auckland, New Zealand. The interviews explored participants' views around the use of de-identified health data for health service improvement and health services research. Data were analysed using thematic analysis.</p><p><strong>Results: </strong>Themes identified were: 1) Benefits: participants believed that there were benefits to sharing their health data such as helping others, improving health services, advancing scientific knowledge, and giving back to the health system; sharing health data was also seen as a reflection of good character, and people felt that their pre-existing views about whether they wished to share health data should be respected even if they were no longer able to consent. 2) Concerns: participants had concerns about sharing data with private companies, the use of inaccurate data, and the potential personal and societal consequences of sharing health data. 3) Expectations: participants encouraged collaboration between institutions in New Zealand, but expected data privacy to be maintained, processes to be transparent and cultural values around data to be respected; there was an expectation those sharing health data (patients or institutions) should benefit from any private sector gains.</p><p><strong>Conclusion: </strong>Older people in our study were supportive of sharing their deidentified health data for research purposes provided that the research would benefit others, now and in the future. This provides more confidence in the use routinely collected health data of older people for research, provided that researchers handle data in a respectful way and use it to benefit communities while avoiding potential harms.</p><p><strong>Trial registration: </strong>NA.</p>","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"26 1","pages":"70"},"PeriodicalIF":3.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aspects of patient rights in a developing country: a qualitative study.","authors":"Deedat Safeer, Sanduni Wijerathne, Pumudu Weerasekara, Udari Wickramasinghe, Sanidi Edirisinghe, Anuki Hewavithana, Nadeeka Chandraratne, Saroj Jayasinghe","doi":"10.1186/s12910-025-01232-2","DOIUrl":"10.1186/s12910-025-01232-2","url":null,"abstract":"<p><strong>Background: </strong>Patients' rights are integral to ensuring ethical and humane healthcare delivery. Understanding these rights helps promote patient-centered care and strengthens trust in healthcare systems. Although international frameworks outline patients' rights comprehensively, Sri Lanka lacks specific legislative recognition and public awareness on the topic. This study aims to explore perspectives on patients' rights in Sri Lanka and identify barriers and facilitators to their implementation.</p><p><strong>Methods: </strong>A qualitative study was conducted at the National Hospital of Sri Lanka, involving individual interviews with twenty participants, including patients (n = 16) from diverse backgrounds and healthcare professionals (n = 4). The study used a generic qualitative inquiry using inductive thematic analysis. Open-ended interviews were transcribed, and key themes were identified based on participants' descriptions of their experiences.</p><p><strong>Results: </strong>The study identified several key themes regarding patient rights: access to information and informed consent, respect and dignity, and quality of care. Patients were generally satisfied with the amount of information received, although healthcare providers desired more patient involvement in decision-making. Both patients and healthcare professionals stressed the importance of treating patients with respect and dignity. However, patients showed a tendency to defer to the expertise of doctors, placing less emphasis on informed consent and their own autonomy. Patients also expressed a right to high-quality care but experienced some delays and inefficiencies.</p><p><strong>Conclusions: </strong>This study reveals both strengths and weaknesses in the implementation of patient rights within the Sri Lankan healthcare setting. A lack of formal recognition of patient rights and a cultural tendency for patients to trust doctors' judgement over their own autonomy are key findings. This study highlights the need to improve patient empowerment and education to promote autonomy and shared decision making in their own care. Future studies should include larger, multi-center samples, to gain a more comprehensive understanding of patient rights in Sri Lanka. Importantly, this study advocates for national policy reform, including the development and adoption of an officially recognized Patient Rights Charter.</p>","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"26 1","pages":"69"},"PeriodicalIF":3.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethical and social considerations of applying artificial intelligence in healthcare-a two-pronged scoping review.","authors":"Emanuele Ratti, Michael Morrison, Ivett Jakab","doi":"10.1186/s12910-025-01198-1","DOIUrl":"10.1186/s12910-025-01198-1","url":null,"abstract":"<p><strong>Background: </strong>Artificial Intelligence (AI) is being designed, tested, and in many cases actively employed in almost every aspect of healthcare from primary care to public health. It is by now well established that any application of AI carries an attendant responsibility to consider the ethical and societal aspects of its development, deployment and impact. However, in the rapidly developing field of AI, developments such as machine learning, neural networks, generative AI, and large language models have the potential to raise new and distinct ethical and social issues compared to, for example, automated data processing or more 'basic' algorithms.</p><p><strong>Methods: </strong>This article presents a scoping review of the ethical and social issues pertaining to AI in healthcare, with a novel two-pronged design. One strand of the review (SR1) consists of a broad review of the academic literature restricted to a recent timeframe (2021-23), to better capture up to date developments and debates. The second strand (SR2) consists of a narrow review, limited to prior systematic and scoping reviews on the ethics of AI in healthcare, but extended over a longer timeframe (2014-2024) to capture longstanding and recurring themes and issues in the debate. This strategy provides a practical way to deal with an increasingly voluminous literature on the ethics of AI in healthcare in a way that accounts for both the depth and evolution of the literature.</p><p><strong>Results: </strong>SR1 captures the heterogeneity of audience, medical fields, and ethical and societal themes (and their tradeoffs) raised by AI systems. SR2 provides a comprehensive picture of the way scoping reviews on ethical and societal issues in AI in healthcare have been conceptualized, as well as the trends and gaps identified.</p><p><strong>Conclusion: </strong>Our analysis shows that the typical approach to ethical issues in AI, which is based on the appeal to general principles, becomes increasingly unlikely to do justice to the nuances and specificities of the ethical and societal issues raised by AI in healthcare, as the technology moves from abstract debate and discussion to real world situated applications and concerns in healthcare settings.</p>","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"26 1","pages":"68"},"PeriodicalIF":3.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring knowledge and attitudes toward electronic informed consent among clinical trial participants in China: a cross-sectional study.","authors":"Ying Wu, Xing Liu, Xiaoying Ge, Xin Tan, Weiwei Yu, Xiaomin Wang","doi":"10.1186/s12910-025-01222-4","DOIUrl":"10.1186/s12910-025-01222-4","url":null,"abstract":"<p><strong>Background: </strong>With the extensive integration of digital technology into clinical research, intelligence, virtualization, and decentralization have gradually transformed into emerging clinical research modes, the electronization of informed consent has become indispensable to the development of clinical trial informatization, and the inclination to use electronic informed consent (eIC) has grown. The knowledge and perceptions of research participants, as objects of informed consent acquisition, regarding eIC are crucial. However, few studies have empirically explored such issues.</p><p><strong>Methods: </strong>This cross-sectional study was conducted at three general hospitals in south-central China from July to September 2022. An online survey questionnaire was adapted and administered via WeChat to investigate the issues of interest.</p><p><strong>Results: </strong>A total of 388 valid questionnaires were included in the analysis. The results showed that the overall response rate for the knowledge section of the questionnaire exceeded 70%. Of the respondents, 53.1% had heard of the term \"electronic informed consent,\" but only 43.2% had used eIC. The majority of respondents (68%) expressed a preference for using eIC and demonstrated a positive attitude toward it. However, some participants expressed concerns regarding the security and confidentiality (64.4%), operational complexity (52.3%), and effectiveness of online interaction (59.3%) in eIC. Statistically significant relationships were observed between participants' attitude scores and their age, gender, type of participation, and frequency of involvement in clinical research. Additionally, a positive and statistically significant correlation was found between participants' knowledge scores and their attitude scores.</p><p><strong>Conclusion: </strong>The results of this study indicate that most participants have a good understanding of eIC-related knowledge and hold a positive attitude toward its implementation. However, they also express concerns about data protection and privacy security in eIC. These findings provide a foundation for developing targeted strategies to enhance the adoption and acceptance of eIC among diverse populations.</p>","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"26 1","pages":"67"},"PeriodicalIF":3.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"It is difficult to be absolutely sure one way or the other.\" - a mixed method study on Finnish physicians' views on euthanasia and physician-assisted suicide.","authors":"Reetta P Piili, Minna Hökkä, Elina Tolvanen, Jukka Vänskä, Pekka Louhiala, Juho T Lehto","doi":"10.1186/s12910-025-01220-6","DOIUrl":"10.1186/s12910-025-01220-6","url":null,"abstract":"<p><strong>Background: </strong>Euthanasia and physician-assisted suicide (PAS) are complex and ethically challenging topics. Physicians' attitudes toward euthanasia and PAS have been studied, but little is known about their ethical considerations regarding these topics. This study aimed to assess Finnish physicians' views on assisted dying (AD), including euthanasia and PAS. Our special emphasis was to describe physicians' views on the legalization of AD, their views on AD as a phenomenon, and how AD reflects on physicians' roles.</p><p><strong>Methods: </strong>A survey including statements and open questions concerning euthanasia and PAS was sent to all Finnish physicians in 2020. The data was analysed using quantitative measures and a qualitative approach.</p><p><strong>Results: </strong>Altogether, 6889 physicians answered the survey, yielding a response rate of 26%. Of the responders, 9% fully agreed that accepting euthanasia would benefit the physician-patient relationship, while 19% fully agreed that it would harm this relationship. From 2565 responders, 3033 answers were received to the open questions. The qualitative analysis yielded two unifying categories, firstly 'Physicians' views on assisted dying (AD) in the current societal situation and on its legalization' included three main categories namely: 'AD and end-of-life issues in the current societal situation' (f = 230), 'Physicians perspectives on legalisation of AD' (f = 605) and 'The possible consequences of legalizing AD' (f = 543). Secondly, the unifying category 'Physicians views on AD as part of their work and as a phenomenon' included two main categories, 'AD and the physicians' professional role (f = 650) and 'AD as a multifaceted phenomenon' (f = 296).</p><p><strong>Conclusion: </strong>Assisted dying is seen as a complex issue, and it was difficult to form an opinion on it. Physicians and the care team are faced with ethical dilemmas about topics related to AD, even though it is not legalized in Finland. Open and pluralistic discussion on AD, including ethical aspects, implications for society and end-of-life care practices is of utmost importance.</p>","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"26 1","pages":"66"},"PeriodicalIF":3.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethics, orthodoxies and defensive practice: a cross-sectional survey of nurse's decision-making surrounding CPR in deceased inpatients without Do Not Resuscitate orders.","authors":"Gemma McErlean, Suzanne Bowdler, Joanne Cordina, Heidi Hui, Edwina Light, Wendy Lipworth, Susan Maitland, Eamon Merrick, Amy Montgomery, Anne Preisz, Linda Sheahan, Suzanne Sheppard-Law, George Skowronski, Cameron Stewart, Judeil Krlan Teus, Michael Watts, Sahn Zanotti, Ian Kerridge","doi":"10.1186/s12910-025-01224-2","DOIUrl":"10.1186/s12910-025-01224-2","url":null,"abstract":"<p><strong>Background: </strong>In hospital, nurses are often the first to identify patients in cardiorespiratory arrest and must decide whether to call a CODE BLUE and commence cardiopulmonary resuscitation (CPR). In Australia, there are no legal or policy obligations to commence CPR when unequivocal signs of death are present. The use of CPR where it cannot provide any benefit to a patient raises profound questions about decision-making and ethical practice. The aim of this empirical ethics study was to describe hospital-based nurses' decision-making, perspectives, and experiences of initiating CPR in hospitalised patients who have unequivocal signs of death but lack a Do-Not-Resuscitate (DNR) order.</p><p><strong>Methods: </strong>The study was a multisite cross-sectional descriptive survey conducted between October 2023-April 2024. Nurses were presented with two clinical scenarios in which patients were found to have no signs of life: Mr. D, an 84-year-old male with cancer, and Mr. G, a 35-year-old male post-motor vehicle accident. Eligible participants were all nurses working in in-patient units. Descriptive statistics, Pearson Chi-square or Fisher's exact tests, McNemar test, and binomial logistic regression were used to analyse the data.</p><p><strong>Results: </strong>531 nurses completed the survey. For Mr D, 61.5% (n = 324) would call a CODE BLUE, 24.1% (n = 127) would perform limited CPR. Only 14.4% (n = 76) would confirm death. For Mr G, 93.9% (n = 492) would call a CODE BLUE, 4.4% (n = 23) would perform limited CPR, and 1.7% (n = 9) would confirm death. The major reasons why nurses initiate a CODE BLUE were 'In the absence of an DNR order, there is no option but to begin CPR', 'I am required by hospital policy to do so', 'I am required by law to do so' and 'It is what I was trained to do'.</p><p><strong>Conclusions: </strong>Most nurses would commence CPR in patients with clear signs of death in the absence of a DNR order. This seems most likely related to ignorance or misunderstanding of law, policy and/or the misapplication or professional norms. These results raise important questions about the drivers of nurses understanding of and engagement with CPR. This highlights ethical concerns for care and treatment of patients at the end of their life and underscores the need to examine ethical practice, agency, and professionalism and supports review of policy, practices and education regarding ethical end-of-life decision making and care.</p>","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"26 1","pages":"65"},"PeriodicalIF":3.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Informed consent and ethics committee involvement in case reports and case series: cross-sectional meta-research study.","authors":"Matea Valešić, Marta Čivljak, Livia Puljak","doi":"10.1186/s12910-025-01226-0","DOIUrl":"10.1186/s12910-025-01226-0","url":null,"abstract":"<p><strong>Background: </strong>Although the research should guarantee the protection of privacy and personal data, case reports and case series frequently lack the involvement of the ethics board and informed consent that includes the required information. This study aimed to analyze the reporting about informed consent and ethics committees in case reports and case series.</p><p><strong>Methods: </strong>This cross-sectional meta-research study analyzed case reports and case series published in 2021, indexed in PubMed, and available as open-access articles. Extracted variables included authorship details, country, journal name, number of cases, and documentation of informed consent and ethics committee approval.</p><p><strong>Results: </strong>This study analyzed 2053 case reports and case series. Most articles (86%) reported a single case. Statements about informed consent were reported in 79% of cases. Informed consent was primarily obtained from patients (74%). Statements about an ethics committee were reported in 46% of articles. In 24% of articles, it was reported that approval was obtained from an ethics committee. Case reports were significantly more likely to include a statement on informed consent than case series. On the contrary, case series were significantly more likely to report ethics committee statements than case reports.</p><p><strong>Conclusion: </strong>The findings reveal inconsistencies in ethics reporting, with 46% of articles mentioning ethics committee involvement and varying justifications for exemption. While 79% of articles reported informed consent, further improvements in transparency and standardization are needed. Clear guidelines on ethical approval requirements and consent documentation should be established to enhance the quality and ethical rigor of case reports.</p>","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"26 1","pages":"64"},"PeriodicalIF":3.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risks and benefits of engaging youth living with HIV in research: perspectives from Kenyan Youth, caregivers, and subject matter experts.","authors":"Emma Gillette, Winstone Nyandiko, Ashley Chory, Michael Scanlon, Josephine Aluoch, Hillary Koros, Celestine Ashimosi, Whitney Biegon, Dennis Munyoro, Janet Lidweye, Jack Nyagaya, Allison DeLong, Rami Kantor, Rachel Vreeman, Violet Naanyu","doi":"10.1186/s12910-025-01225-1","DOIUrl":"10.1186/s12910-025-01225-1","url":null,"abstract":"<p><strong>Background: </strong>Involving children and adolescents (youth) living with HIV (YLWH) in research is critical for developing appropriate HIV care services and interventions. However, this vulnerable population may not adequately weigh risks against benefits when participating in research, forming an ethical concern, yet little is known about how YLWH perceive these risks and benefits. To inform research-related policies and procedures, we sought perspectives of Kenyan YLWH, their caregivers and subject matter experts (SMEs) on risks and benefits of participation in research in a setting with a high burden of youth HIV infection.</p><p><strong>Methods: </strong>We conducted a qualitative inquiry on identifying, enrolling, and protecting YLWH (age 10-24 years) in research using semi-structured interviews with YLWH involved in research, their caregivers, YLWH with no prior research experience, and other SMEs at the AMPATH care and research sites in western Kenya. Transcripts were thematically analyzed and emerging themes derived to characterize perspectives of each group on risks and benefits of engaging YLWH in research.</p><p><strong>Results: </strong>Interviews were conducted with 40 YLWH (50% female; median age 17.5 years), 20 caregivers (70% female), and 39 SMEs [healthcare providers (N = 10), community leaders (N = 10) community advisory board members (N = 4), IRB experts (N = 5), clinical researchers (N = 6), social science researchers (N = 4) and laboratory experts (N = 1).] Participants in all groups identified accidental disclosure of HIV status, stigma and discrimination, risks of blood draws, mental health effects, and coercion due to study compensation as risks of research involvement. Benefits fell into 5 categories: clinical, informational, personal, future and community or household benefits. Benefits included access to health care, learning about HIV, gaining hope and community, improving HIV care, and reducing stigma. All participant groups largely held similar views; however, caregivers were the only group to identify misuse of study compensation as a risk, and YLWH less frequently cited clinical benefits.</p><p><strong>Conclusion: </strong>These findings suggest that participants commonly cite indirect risks and benefits of research participation, yet these are often excluded from institutional guidelines for consent documentation. Researchers should consider including indirect risks and benefits, such as the risk of stigma or the benefit of gaining knowledge and community, to study documentation.</p>","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"26 1","pages":"63"},"PeriodicalIF":3.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A literature review of non-financial conflicts of interest in healthcare research and publication.","authors":"David Bauer, Devin A Orchard, Philip G Day, Marc Tunzi, David J Satin","doi":"10.1186/s12910-025-01221-5","DOIUrl":"https://doi.org/10.1186/s12910-025-01221-5","url":null,"abstract":"<p><strong>Background: </strong>Conflicts of interest (COIs) in healthcare research have received substantial attention over the past three decades. Although financial COI (FCOI) has an extensive literature, publications about non-financial COI (NFCOI) are comparatively rare. Disagreements surrounding the importance of NFCOIs in research and publication, including whether competing non-financial interests should even be considered COIs, present significant gaps in the literature. This lack of clarity prompted our literature review's aim to determine the current consensus about how NFCOIs should be treated in healthcare research and publication.</p><p><strong>Methods: </strong>We searched the PubMed database using MeSH terms and keywords to identify articles published before November 6, 2023 about NFCOI in biomedical research and publication. We applied relevance, appropriateness, transparency, and soundness (RATS) criteria to develop a final dataset of 206 publications and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram. Qualitative and quantitative analyses revealed major themes and conclusions regarding consensus within the field.</p><p><strong>Results: </strong>The literature centers around fundamental disagreements about (1) whether competing non-financial interests constitute COIs like FCOIs, (2) whether they need to be addressed in research, and (3) whether they should be managed with disclosure or with other strategies. Despite these disagreements, the balance of evidence and arguments suggests that (1) NFCOIs are meaningful conceptual entities like FCOIs [96%], (2) they require management [76%], and (3) disclosure is necessary but insufficient [55%] or necessary and sufficient [27%] as a management strategy.</p><p><strong>Conclusion: </strong>The topic of NFCOI enjoys far less attention and consensus compared to FCOI's robust body of literature developed over decades. We found general agreement about the relevance of NFCOIs and the need to address them, but not how to do so. Our results are consistent with Wiersma et al., the first review on this topic. Taken together, these reviews suggest a path forward for researchers, publishers, and healthcare professionals requiring new approaches for NFCOI management.</p>","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"26 1","pages":"61"},"PeriodicalIF":3.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do mental or somatic diagnoses influence emotional response and perception of physician-assisted suicide in Germany? A vignette-based experiment.","authors":"Laura Hofmann, Birgit Wagner","doi":"10.1186/s12910-025-01223-3","DOIUrl":"10.1186/s12910-025-01223-3","url":null,"abstract":"<p><strong>Background: </strong>Physician-assisted suicide (PAS) is increasingly being legalized in a growing number of countries and is the focus of societal and ethical debates. However, there is limited knowledge regarding the perception and acceptance of PAS across different physical and mental health conditions. This study aimed to explore emotional responses, understanding, and willingness to support individuals with the wish for PAS.</p><p><strong>Methods: </strong>Participants from the general German population (N = 512) were presented with four case vignettes of PAS depicting individuals in an online study: one with cancer, one with depression, one with schizophrenia, and one healthy individual. Participants were asked to evaluate the emotional reactions elicited by the desire for PAS, the extent of their understanding of this wish, and their willingness to support each individual.</p><p><strong>Results: </strong>The study revealed significant differences in reactions to the case vignettes. Pro-social emotions were lowest and anger highest when considering the healthy individual. Participants demonstrated the greatest understanding and highest willingness to support the individual with cancer, while the least understanding and support were observed for the healthy person.</p><p><strong>Conclusions: </strong>The differential levels of support for PAS across various conditions underscore the complex interplay between societal values, perceived quality of life, and ethical considerations, particularly when mental health is involved.</p>","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"26 1","pages":"62"},"PeriodicalIF":3.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12079990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}