BMC Medical Ethics最新文献

{"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":"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}

{"title":"Attitudes of physicians, nurses, and the general public toward End-of-Life (EoL) decisions in European countries: an umbrella review.","authors":"Pietro Refolo, Costanza Raimondi, Salvatore Simone Masilla, Antonina Argo, Emma Capulli, Silvia Ceruti, Silvia Gonella, Francesca Ingravallo, Guido Miccinesi, Mario Picozzi, Pietro Redaelli, Antonio Gioacchino Spagnolo","doi":"10.1186/s12910-025-01219-z","DOIUrl":"10.1186/s12910-025-01219-z","url":null,"abstract":"<p><strong>Background: </strong>End-of-life (EoL) decisions represent some of the most ethically complex and emotionally charged aspects of healthcare. Understanding the attitudes of physicians, nurses, and the public toward EoL decisions is crucial for aligning care provided with the personal values and preferences of patients.</p><p><strong>Aim: </strong>To explore the attitudes of physicians, nurses, and the general public toward EoL decisions, including the withdrawal or withholding of life-sustaining treatments, euthanasia, physician-assisted suicide (PAS), palliative sedation, and advance care planning (ACP) within European countries.</p><p><strong>Design: </strong>An umbrella review was conducted, covering the period from January 2010 to June 2024. The search strategy included Medline, CINAHL, and PsycINFO, supplemented by manual searches of reference lists of all included studies to identify additional relevant studies.</p><p><strong>Results: </strong>The search identified 587 papers, 11 of which were included in the synthesis. Of these, six addressed euthanasia and PAS, three focused on ACP, one on the withdrawal of life-sustaining treatments, and one on palliative sedation. In Europe, the general public expressed the highest level of support for EoL practices such as euthanasia and PAS, followed by nurses, while physicians often held a more cautious perspective. For withdrawal of treatment, palliative sedation, and ACP, a critical recurring theme was the need to improve communication between patients and healthcare professionals.</p><p><strong>Conclusions: </strong>The divergence underscores the intricate complexity of navigating ethical, cultural, and professional considerations in EoL care. Effective communication serves as a cornerstone for respecting patient autonomy and ensuring that healthcare decisions align with individual values, goals and preferences.</p>","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"26 1","pages":"60"},"PeriodicalIF":3.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046508","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":"Perception of the ethical climate among hospital employees in a public healthcare system: a cross-sectional survey at the University Hospital of Split, Croatia.","authors":"Zrinka Hrgović, Luka Ursić, Jure Krstulović, Marin Viđak, Ljubo Znaor, Ana Marušić","doi":"10.1186/s12910-025-01217-1","DOIUrl":"https://doi.org/10.1186/s12910-025-01217-1","url":null,"abstract":"<p><strong>Background: </strong>In this cross-sectional study, we assessed the ethical climate at the University Hospital of Split in Croatia and investigated its potential indicators.</p><p><strong>Methods: </strong>We used a validated Croatian translation of the 36-item Ethical Climate Questionnaire, which we distributed online (via an e-mail sent by the hospital administration to hospital employees) and as a paper and pen survey directly to all hospital departments. We compared ECQ scores between doctors of medicine (MDs)/doctors of dental medicine (DMDs) and other employees; MDs/DMDs and nurses; employees working with patients and those not working with patients; and employees working in the ICU versus those not working in the ICU using the Mann-Whitney U test. We used linear regression to explore the relationship of each ethical climate with gender, age, degree level, and years spent working in the hospital.</p><p><strong>Results: </strong>We collected 325 physical and 222 online questionnaires (547 responses in total), after which we excluded 146 incomplete responses. This left 401 questionnaires for analysis, primarily from doctors (n = 175; 43.6%) and nursing staff (n = 131; 32.7%). The two dominant climates were 'Company rules' and 'Laws and professional codes'. Stratified by profession, we observed higher scores for 'Personal morality' among doctors of medicine or dental medicine, whereas the group comprising other health professionals and non-medical staff had higher scores for 'Team interests', 'Efficiency', 'Social responsibility', and 'Laws and professional codes'. In comparing nurses and doctors of medicine/dental medicine, we observed the former group had higher scores for 'Social responsibility', 'Efficiency', and 'Team interest', while the latter had higher scores for 'Personal morality'. Those who worked outside of the ICU had higher scores for 'Social responsibility' compared to those who did not. In the regression analyses, age was a significant positive predictor of the 'Laws and professional codes' climates, and years spent working in the hospital acted as a positive predictor of the 'Self-interest' climate.</p><p><strong>Conclusion: </strong>A large university hospital center in a fully publicly funded national healthcare system has a positive ethical work climate, which could be further developed by further development and implementation of codes of ethics to outline expected behaviors from all employees.</p>","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"26 1","pages":"59"},"PeriodicalIF":3.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040872","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":"Why did not all studies conducted during Darfur's armed conflict obtain ethics approval? Insights from a qualitative study.","authors":"Ghaiath Hussein, Khalifa Elmusharaf","doi":"10.1186/s12910-025-01194-5","DOIUrl":"https://doi.org/10.1186/s12910-025-01194-5","url":null,"abstract":"<p><strong>Background: </strong>Armed conflicts are associated with multiple factors that may deem applying the ethical standards of research conducted in war-affected areas hard to achieve, compared to research conducted in peace time.</p><p><strong>Objective: </strong>Using the example of studies conducted by the humanitarian agencies in the war-troubled region of Darfur, west Sudan between 2004 and 2012, a qualitative study was pursued to have a deeper understanding of the factors that affected the reporting of gaining the ethical approval in the published reports of these studies.</p><p><strong>Methods: </strong>A qualitative study was used that involved conducting interviews and focus groups with the relevant stakeholders, namely the representatives of the national and international non-governmental organizations, UN agencies, and the national humanitarian and research governance bodies in Sudan.</p><p><strong>Results: </strong>38 participants were involved (5 interviewees and 33 participants in the focus groups). The participants expressed a consensus on the need for an ethical oversight for research in the humanitarian settings in Sudan and particularly Darfur. Following a thematic analysis, four main themes were identified to explain why the humanitarian studies in Darfur were not submitted to formal ethical approval. These are (1) Inconsistent definitions of research, (2) Perceptions of low-risk, (3) Perceived urgency due to emergency context, (4) Prior study or tool approval, and (5) Lack of knowledge about ethics review procedures.</p><p><strong>Conclusion: </strong>Institutional gaps in humanitarian governance structures are identified, urging the need for specialized ethics oversight mechanisms. The dynamic nature of humanitarian crises prompts nuanced approaches to ethical scrutiny, emphasizing policy initiatives to harmonize research and humanitarian governance frameworks and learning lessons from research ethics oversight in public health emergencies.</p>","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"26 1","pages":"58"},"PeriodicalIF":3.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000205","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":"Health leaders' perspectives and attitudes on medical assistance in dying and its legalization: a qualitative study.","authors":"Amanda Yee, Eryn Tong, Rinat Nissim, Camilla Zimmermann, Sara Allin, Jennifer L Gibson, Madeline Li, Gary Rodin, Gilla K Shapiro","doi":"10.1186/s12910-025-01208-2","DOIUrl":"https://doi.org/10.1186/s12910-025-01208-2","url":null,"abstract":"<p><strong>Background: </strong>Medical Assistance in Dying (MAiD) has transformed health policy and practice on death and dying. However, there has been limited research on what shaped its emergence in Canada and the beliefs and views of health leaders who hold positions of influence in the healthcare system and can guide policy and practice. The objective of this study was to examine health leaders' perspectives on the factors that led to the emergence of MAiD and explore their attitudes about the legalization of MAiD.</p><p><strong>Methods: </strong>In this qualitative study, we conducted online semi-structured interviews with health leaders from April 2021 to January 2022. Purposive and snowball sampling techniques were used to recruit health leaders who have expertise and engagement with the delivery of MAiD or palliative and end-of-life care, and who hold positions of leadership relevant to MAiD in their respective organisations. Inductive thematic analysis was used to analyze the transcribed interviews.</p><p><strong>Results: </strong>Thirty-six health leaders were interviewed. Participants identified six factors that they believed to have led to the introduction of MAiD in Canada: public advocacy and influence; judicial system and notable MAiD legal cases; political ideology and landscape; policy diffusion; healthcare system emphasis on a patient-centred care approach; and changes in societal and cultural values. Participants expressed wide-ranging attitudes on the legalization of MAiD. Some described overall agreement with the introduction of MAiD, while still raising concerns regarding vulnerability. Others held neutral attitudes and indicated that their attitudes changed on a case-by-case basis. Participants described four factors that they considered to have had influence on their attitudes: personal illness experiences; professional experiences and identity; moral and religious beliefs; and, the valence of patient autonomy and quality of life.</p><p><strong>Conclusions: </strong>This study highlights the wide-ranging and complex attitudes health leaders may hold towards MAiD and identifies the convergence of multiple factors that may have contributed to the legalization of MAiD in Canada. Understanding health leaders' attitudes and perspectives on the legalization of MAiD may inform stakeholders in other countries who are considering the legalization of assisted dying.</p>","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"26 1","pages":"57"},"PeriodicalIF":3.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058847","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 balancing act: exploring ethical and legal concerns associated with release of personal information in alert systems for missing persons with dementia.","authors":"Adebusola Adekoya, Christine Daum, Antonio Miguel-Cruz, Lili Liu","doi":"10.1186/s12910-025-01214-4","DOIUrl":"10.1186/s12910-025-01214-4","url":null,"abstract":"<p><strong>Background: </strong>Technology, such as alert systems, can foster community engagement in locating missing persons with dementia and minimize potential harm. However, concerns arise about implications of public disclosure of missing individual's personal information (such as age, photographs, physical descriptions, and medical conditions) within alert systems. Until now, there has been no review of these concerns, particularly in the Canadian context. Our study aimed to explore community members' perspectives on the ethical and legal concerns associated with the release of personal information in alert systems for missing persons with dementia.</p><p><strong>Methods: </strong>Using a qualitative descriptive approach, we conducted semi-structured interviews with 18 participants: people living with dementia, care partners, service providers, first responders, and experts in ethics, policy, and the law from Canada and the United Kingdom. We conducted a thematic analysis of the interview data to inductively explore ethical and legal concerns.</p><p><strong>Results: </strong>Our findings identified the following concerns: Balancing safety and privacy, stigmatization, risk of victimization and abuse, and informed consent. There is a challenge of balancing safety with privacy due to the urgency of locating missing persons when sharing personal information publicly. Disclosure of personal information, such as cognitive impairment, can increase the risk of stigmatization, victimization, and abuse for both the missing individuals and their care partners. Unfortunately, conversations about alert systems and consent do not typically occur before someone goes missing, even though people living with dementia have the right to participate in these conversations.</p><p><strong>Conclusions: </strong>Alert systems can promote community involvement in locating missing persons with dementia but must balance safety and privacy concerns. Implementation of education and policies would mitigate stigmatization, victimization, and abuse. Early conversations with people living with dementia and their care partners to understand their preferences, along with an advance consent process, can help address consent concerns. Our framework, which emphasizes ethical and legal considerations, can guide policy, practice, and decision-making to support the autonomy of people living with dementia.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"26 1","pages":"56"},"PeriodicalIF":3.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013020","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":"Surgical consent, perception of the patients who underwent a surgical operation in the Kurdistan region, Iraq.","authors":"Dawan Jamal Hawezy","doi":"10.1186/s12910-025-01218-0","DOIUrl":"https://doi.org/10.1186/s12910-025-01218-0","url":null,"abstract":"<p><strong>Introduction: </strong>Patient satisfaction is a significant measure of healthcare service quality as the patient is the center of any surgical procedure. Patient satisfaction refers to the extent to which a patient's expectations of optimal care align with their perception of the care received. Patient satisfaction during informed consent is enhanced when written informed consent is accompanied by verbal consent in the preoperative period. Satisfied patients are more inclined to adhere to therapy, engage actively in their care, utilize healthcare services, willingly partake in decision-making, and remain with a healthcare provider. This research examines the practical and ethical considerations of obtaining informed consent during surgical procedures. To better understand and make informed decisions, this study aims to assess the efficacy of present consent methods and pinpoint obstacles patients encounter.</p><p><strong>Methodology: </strong>A cross-sectional study was conducted from April to December 2024. Data were gathered by second-year students from Koya University's Faculty of General Medicine by interviewing postoperative patients who had undergone general surgical procedures. The results were entered into a Google form and analyzed using SPSS27.</p><p><strong>Results: </strong>In interviews with participants, 430 out of 572 patients (75%) indicated trust in their surgeons performing the surgery, while 525 patients (91%) expressed respect for their surgeons' opinions. However, 41% (239 patients) reported not reading the informed consent form, and a similar percentage denied that the details of the form were explained by the medical staff responsible for the surgery as there are some medical terms or situations in the form that are challenging to assume if not explained.</p><p><strong>Conclusion: </strong>Compared to others, participants with a higher educational level sought extensive time from the responsible surgeons to discuss every detail of the surgery before signing the informed consent, with a statistically significant difference observed. A similar difference was noted between private and public hospitals.</p>","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"26 1","pages":"55"},"PeriodicalIF":3.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043319","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 scoping review of the ethical issues in gender-affirming care for transgender and gender-diverse individuals.","authors":"Shilpa Surendran, Hui Jin Toh, Teck Chuan Voo, Chuan De Foo, Michael Dunn","doi":"10.1186/s12910-025-01216-2","DOIUrl":"https://doi.org/10.1186/s12910-025-01216-2","url":null,"abstract":"<p><strong>Background: </strong>Globally, there is a notable increase in recognising the health needs of transgender and gender-diverse individuals. As a result, gender-affirming care services are evolving and expanding in many parts of the world, and this has provoked increased debate on various aspects of the interventions that comprise such care. Resolution of these debates depends on addressing important ethical issues. This scoping review aims to identify the key ethical issues and arguments regarding gender-affirming care across various medical interventions.</p><p><strong>Methods: </strong>We searched Embase, PubMed and SCOPUS to identify peer-reviewed publications that could meet some eligibility criteria such as publications presenting an ethical issue, argument, or principle related to gender-affirming care for transgender and gender-diverse individuals and having been published from 2012 to 2023. We applied Arksey and O'Malley's scoping review framework. The text of included publications was analysed inductively.</p><p><strong>Results: </strong>Eighty-two publications were identified for inclusion. Sixty-two publications (76%) were published in or after 2019, and 20 (24%) between 2012 and 2018. Five aspects of gender-affirming care that draw ethical analysis or debates were identified: decision-making process, guideline and model of care, deletion of health data, funding, and fertility preservation and services. Ethical issues and arguments were identified within each aspect of care. The arguments are organised according to the four principles of biomedical ethics: autonomy, beneficence, non-maleficence and justice.</p><p><strong>Conclusion: </strong>This scoping review captures the key ethical issues in various aspects of gender-affirming care. There were substantial differences in the depth to which each aspect of gender-affirming care was discussed, with ethical issues in decision-making processes receiving the most attention, and deletion of health data given the least attention. This review also characterises the dominant ethical arguments and underlying principles used to justify positions on the issues. Within each ethical issue, the four principles of biomedical ethics featured commonly, but were applied very differently and accorded unequal weighting. Additionally, in some discussions, arguments supporting medical interventions were given more attention; in others, the rationales opposing medical interventions were dominant. Perhaps unsurprisingly, there was limited resolution and increasing disagreement. Important constraints in the methodologies of argumentation used to support or oppose aspects of gender-affirming care were also identified.</p>","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"26 1","pages":"54"},"PeriodicalIF":3.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060915","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":"Confidentiality and family involvement in healthcare: a mixed-method approach of physicians' perspectives in Jordan.","authors":"Reema Karasneh, Sayer Al-Azzam, Mohammad Nusair, Abdel-Hameed Al-Mistarehi, Mamoon A Aldeyab, Islam Massad","doi":"10.1186/s12910-025-01213-5","DOIUrl":"https://doi.org/10.1186/s12910-025-01213-5","url":null,"abstract":"<p><strong>Background: </strong>With the evolving person-centered care approach, the importance of family involvement is increasingly recognized to promote comprehensive treatment. However, determining when and how to disclose patient information to families without compromising privacy rights while ensuring optimal patient care poses an ethical challenge. Therefore, we aimed to explore physicians' attitudes regarding sharing patient data with family members and protecting patient information.</p><p><strong>Methods: </strong>A convergent (i.e., concurrent) mixed-methods approach was employed, integrating quantitative data collected through a questionnaire distributed to physicians and qualitative data were obtained through semi-structured interviews.</p><p><strong>Results: </strong>Data from 221 physicians in Jordan revealed that only 48% would consistently seek patient consent before data disclosure, with the majority agreeing that they would share patient information with families under circumstances where family assistance is crucial (n = 180, 81.4%) or when the patient is unable to understand the information (n = 181, 81.9%). This was justified by the active involvement of family members in the treatment process (n = 182, 81.4%). Qualitative data from 14 physicians were obtained, and their perspectives revealed two main themes: 1) \"Attitudes Toward Data Sharing with Patients' Families,\" which encompassed \"inability of patients to make decisions,\" \"family involvement due to concerns,\" and \"pressure from family members and 2) \"Significance of Patient Confidentiality \" which included \"building patient trust\" and \"preventing harm to patients.\"</p><p><strong>Conclusion: </strong>A balanced approach that addresses complexities in patient data disclosure and family involvement in healthcare is necessary for fostering trust, supporting informed decision making and facilitating better health outcomes.</p>","PeriodicalId":55348,"journal":{"name":"BMC Medical Ethics","volume":"26 1","pages":"52"},"PeriodicalIF":3.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034103","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}