BMC Medical Ethics最新文献

{"title":"Developing a contextually and culturally relevant benefit-sharing framework for pathogen genomic research and biobanking in africa: a deliberative expert approach.","authors":"Pamela Emefa Selormey, Irene H Tsey, John Ganle, Patricia Akweongo, Paulina Tindana","doi":"10.1186/s12910-025-01238-w","DOIUrl":"10.1186/s12910-025-01238-w","url":null,"abstract":"<p><strong>Background: </strong>Globally, researchers are struggling to implement benefit-sharing plans in genomics research and biobanking. In the African context, there are currently limited benefit-sharing frameworks to guide researchers, and some often rely on personal relationships and judgments in making decisions. Consequently, there have been calls for the development of contextually and culturally relevant benefit-sharing frameworks for pathogenic research and biobanking in Africa. This study responds to that call by using a deliberative experts approach to propose and develop a benefit-sharing framework for pathogen genomic research and biobanking.</p><p><strong>Methods: </strong>Data were collected through deliberative expert key informant interviews. A total of 25 participants, comprising genomics researchers, policymakers, Nagoya Protocol Focal persons, members of institutional review boards, Sponsors and Experts in the field of genomics and biobanking were purposively sampled from 12 countries. Open-ended topic guides were designed and used to facilitate the interviews. The interviews explored issues such as the need for a benefit-sharing framework, the principles underpinning the practice of benefit-sharing, and key features of a possible benefit-sharing framework. Interviews were conducted in English, audio-recorded, and transcribed. Transcripts were imported into Nvivo 14 software, coded and analysed using the framework approach for qualitative data analysis.</p><p><strong>Results: </strong>The participants reported on the key issues to consider in the development of a benefit-sharing framework. These included motivations for sharing benefits, key elements of a benefit-sharing framework and suggestions for monitoring the implementation of the framework. Based on these expert responses, we proposed and developed a three-phase framework. The first phase presents the contextual benefit-sharing process, which includes the benefit-sharing process, iterative benefit-sharing cycles and post-benefit-sharing responsibilities. The second phase comprises the implementation phase with templates on a step-by-step approach to achieving the three areas in phase 1 and the third concentrates on workplans to accommodate future emerging issues such as designing strategies to map out best practices on benefit-sharing, making efforts to publish the selected strategy and implementing the selected benefit-sharing.</p><p><strong>Conclusions: </strong>The deliberative approach used in this study allowed for not only contextually and culturally relevant factors to be identified but also enabled reflexive decision-making. The framework developed has the potential to provide practical guidance to pathogen genomic stakeholders in the identification and implementation of benefit-sharing opportunities in their research programmes. More empirical studies are however required to test and evaluate the framework.</p><p><strong>Clinical trial number: </strong>Not a","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"26 1","pages":"77"},"PeriodicalIF":3.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562071","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":"Should healthcare professionals include aspects of environmental sustainability in clinical decision-making? A systematic review of reasons.","authors":"Sarah Gabriela Kuiter, Alina Herrmann, Marcel Mertz, Claudia Quitmann, Sabine Salloch","doi":"10.1186/s12910-025-01230-4","DOIUrl":"10.1186/s12910-025-01230-4","url":null,"abstract":"","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"26 1","pages":"78"},"PeriodicalIF":3.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562074","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":"Proactive vs. passive algorithmic ethics practices in healthcare: the moderating role of healthcare engagement type in patients' responses.","authors":"Sheng Shu, Qinglin Luo, Zhiqing Chen","doi":"10.1186/s12910-025-01236-y","DOIUrl":"10.1186/s12910-025-01236-y","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) is transforming healthcare, but concerns about algorithmic biases and ethical challenges hinder patient acceptance. This study examined the effects of proactive versus passive algorithmic ethics practices on patient responses across different healthcare engagement types (privacy-focused vs. utility-focused).</p><p><strong>Methods: </strong>We conducted a 2 × 2 online experiment with 513 participants in China. The experiment manipulated the healthcare provider's algorithmic ethics approach (proactive vs. passive) and the healthcare engagement type (privacy-focused vs. utility-focused). Participants were randomly assigned to view a scenario describing a hospital's AI diagnostic system, then completed measures of attitudes, trust, and intentions to use the AI-enabled service.</p><p><strong>Results: </strong>Proactive algorithmic ethics practices significantly increased positive attitudes, trust, and usage intentions compared to passive practices. The positive impact of proactive practices was stronger for privacy-focused healthcare (e.g., mental health services) compared to utility-focused services emphasizing care optimization.</p><p><strong>Conclusions: </strong>This study underscores the critical role of proactive, context-specific algorithmic ethics practices in cultivating patient trust and engagement with AI-enabled healthcare. To optimize outcomes, healthcare providers must strategically adapt their ethical governance approaches to align with the unique privacy-utility considerations that are most salient to patients across different healthcare contexts and AI use cases.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"26 1","pages":"73"},"PeriodicalIF":3.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250925","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":"Navigating healthcare decision-making for children requiring life-sustaining medical treatment in Ireland: exploring clinician perspectives through the lens of the Irish legal system.","authors":"M Brenner, J Lombard, M Quirke, L Cassidy, D Alexander","doi":"10.1186/s12910-025-01237-x","DOIUrl":"10.1186/s12910-025-01237-x","url":null,"abstract":"<p><p>Healthcare decision-making within the pediatric population is a complex area to navigate for clinicians, parents and/or legal guardians, and children, and is even more complicated when children require intensive life-sustaining medical treatment (LSMT). Literature has highlighted the key ethical and legal principles that clinicians involved in bioethics committees should follow when making complex clinical decisions for this population, however, it can be unclear exactly where and how these decisions are made in practice. This paper provides an insight into how healthcare decision-making for children requiring LSMT is navigated within the medical and legal environment in Ireland. It uses a unique methodology consisting of a combination of secondary qualitative analysis of interview data obtained from clinicians involved in bioethics committees, and an analysis of Irish case law. The results of this paper highlight how clinicians navigate bioethical pediatric healthcare decision-making in Ireland, in the context of decisions regarding LSMT. The findings illustrate the complex balancing act that clinicians face in recognising and respecting parental autonomy in shared decision-making whilst being responsible for medical care that prioritises the best interests of the child, particularly from a legal standpoint. In some instances, this creates a decisional discord, and further training and professional supports are needed within clinical practice to promote the needs of children and to reduce stakeholder conflict.</p>","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"26 1","pages":"72"},"PeriodicalIF":3.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12144792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250924","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":"Mapping ethical issues encompassing end-of-life care for persons experiencing severe and persistent mental illness: a qualitative study.","authors":"Loïc Moureau, Monica Verhofstadt, Caressa Van Hoe, Joris Vandenberghe, Chantal Van Audenhove, Axel Liégeois","doi":"10.1186/s12910-025-01234-0","DOIUrl":"10.1186/s12910-025-01234-0","url":null,"abstract":"<p><strong>Background: </strong>Persons experiencing severe and persistent mental illness (SPMI) represent a small but vulnerable group in mental health care and society. Research on this population is limited, despite significant ethical challenges in their care. These challenges include the severity of their illness, limited social networks, communication difficulties, impaired decision-making capacity, and, at times, disruptive behavior.</p><p><strong>Purpose: </strong>This study aims to explore the ethical themes that emerge in the care of persons experiencing SPMI, both in general and at the end of life. Specifically, we examine which issues arise, how care teams address ethical dilemmas, who is involved in decision-making, and what ethical frameworks or practices are utilized.</p><p><strong>Methods: </strong>We conducted 73 in-depth qualitative interviews with care users, family members, caregivers, care managers, and experts from the Flemish region of Belgium. The data were analyzed through content analysis to identify recurring themes and reflect on ethical practices.</p><p><strong>Results: </strong>The findings reveal that while many facilities have ethical guidelines or advisory structures such as ethics committees, these are often not well known or not perceived as easily accessible to frontline staff. Ethical dilemmas are predominantly addressed at the team level, with some organizations employing a reference person ethics in the unit, \"ethics pubs\", or peer support mechanisms for challenging situations. The most frequently mentioned ethical issue was euthanasia, whereas others included neglect in home settings, prolonged delays in initiating palliative care, and maintaining autonomy for care users. Resource allocation, both at the organizational and societal levels, was also identified as an ethical concern. Caregivers described tensions between creative, individualized care and institutional policies, whereas families emphasized the shared responsibility in finding appropriate care.</p><p><strong>Conclusion: </strong>Ethical care for persons experiencing SPMI demands attention to autonomy, collaboration, and resource distribution. Greater accessibility to ethical support systems and tailored approaches are needed to balance recovery-oriented care with a palliative care approach, ensuring dignity and respect for this vulnerable group.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"26 1","pages":"71"},"PeriodicalIF":3.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210339","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":"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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124040/pdf/","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":"OA","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}