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  1. “Doc, I’m Going for a Walk”: Liberalizing or Restricting the Movement of Hospitalized Patients—Ethical, Legal, and Clinical Considerations.David Alfandre, Sara Stream & Cynthia Geppert - 2020 - HEC Forum 32 (3):253-267.
    When patients are admitted to the hospital, they are generally expected to remain in or within close proximity to their assigned rooms in order to promote their safety and appropriate medical care. Although there are circumstances when patients may safely leave their hospital room or floor, guidance within the medical literature for the management of patient movement within the hospital are lacking. Excessive restrictions on patient movement may be seen as overly paternalistic, while lax requirements may interfere with high quality (...)
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  • Medical Assistance in Dying at a paediatric hospital.Carey DeMichelis, Randi Zlotnik Shaul & Adam Rapoport - 2019 - Journal of Medical Ethics 45 (1):60-67.
    This article explores the ethical challenges of providing Medical Assistance in Dying (MAID) in a paediatric setting. More specifically, we focus on the theoretical questions that came to light when we were asked to develop a policy for responding to MAID requests at our tertiary paediatric institution. We illuminate a central point of conceptual confusion about the nature of MAID that emerges at the level of practice, and explore the various entailments for clinicians and patients that would flow from different (...)
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  • Written institutional ethics policies on euthanasia: an empirical-based organizational-ethical framework.Joke Lemiengre, Bernadette Dierckx de Casterlé, Paul Schotsmans & Chris Gastmans - 2014 - Medicine, Health Care and Philosophy 17 (2):215-228.
    As euthanasia has become a widely debated issue in many Western countries, hospitals and nursing homes especially are increasingly being confronted with this ethically sensitive societal issue. The focus of this paper is how healthcare institutions can deal with euthanasia requests on an organizational level by means of a written institutional ethics policy. The general aim is to make a critical analysis whether these policies can be considered as organizational-ethical instruments that support healthcare institutions to take their institutional responsibility for (...)
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  • Quality of ethical guidelines and ethical content in clinical guidelines: the example of end-of-life decision-making.D. Strech & J. Schildmann - 2011 - Journal of Medical Ethics 37 (7):390-396.
    Background While there are many guidelines on how to make ethical decisions at the end of life, there is little evidence regarding the quality of this sort of ethical guidelines. Objectives First, this study aims to demonstrate the conceptual transferability of the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument for the quality assessment of ethical guidelines. Second, it aims to illustrate the status quo of the quality of guidelines on end-of-life decision-making by using the AGREE instrument in a (...)
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  • Balancing competing interests and obligations in mental health‐care practice and policy.Jeffrey Kirby - 2019 - Bioethics 33 (6):699-707.
    It is often challenging for mental health‐care providers and health organizations to perform their various roles and to meet their varied obligations. In complex mental health‐care circumstances the concurrent application of relevant ethical principles and values often leads to the emergence of completing obligations that need to be carefully weighed and balanced in the making of care‐related decisions. Although some clinical circumstances, such as those potentially triggering the duty to warn, are adequately guided by existing rules based on legal precedents, (...)
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  • Organizational Influences on Health Professionals’ Experiences of Moral Distress in PICUs.Sarah Wall, Wendy J. Austin & Daniel Garros - 2016 - HEC Forum 28 (1):53-67.
    This article reports the findings of a qualitative study that explored the organizational influences on moral distress for health professionals working in pediatric intensive care units across Canada. Participants were recruited to the study from PICUs across Canada. The PICU is a high-tech, fast-paced, high-pressure environment where caregivers frequently face conflict and ethical tension in the care of critically ill children. A number of themes including relationships with management, organizational structure and processes, workload and resources, and team dynamics were identified. (...)
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  • Why the “Appraisal of Guidelines for Research and Evaluation” Instrument Can and Should Further Inform Ethics Policy Work.Daniel Strech & Jan Schildmann - 2012 - American Journal of Bioethics 12 (11):25-27.
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  • Is once always enough? Revisiting the single use item.A. Moszczynski - 2009 - Journal of Medical Ethics 35 (2):87-90.
    The reuse of single use medical items is a complex ethical issue that many healthcare providers are faced with, for while recommendations and literature do not advocate the reuse of these items, the reality is that many single use items are frequently reused. Further, many healthcare workers are ethically divided over whether or not to share this information with their patients, or who should reveal this information. While single use items are convenient to use, the reality of the cost to (...)
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  • Opening the Black Box of Ethics Policy Work: Evaluating a Covert Practice.Andrea Frolic, Katherine Drolet, Kim Bryanton, Carole Caron, Cynthia Cupido, Barb Flaherty, Sylvia Fung & Lori McCall - 2012 - American Journal of Bioethics 12 (11):3-15.
    Hospital ethics committees (HECs) and ethicists generally describe themselves as engaged in four domains of practice: case consultation, research, education, and policy work. Despite the increasing attention to quality indicators, practice standards, and evaluation methods for the other domains, comparatively little is known or published about the policy work of HECs or ethicists. This article attempts to open the ?black box? of this health care ethics practice by providing two detailed case examples of ethics policy reviews. We also describe the (...)
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  • “It’s intense, you know.” Nurses’ experiences in caring for patients requesting euthanasia.Yvonne Denier, Bernadette Dierckx de Casterlé, Nele De Bal & Chris Gastmans - 2010 - Medicine, Health Care and Philosophy 13 (1):41-48.
    The Belgian Act on Euthanasia came into force on 23 September 2002, making Belgium the second country—after the Netherlands—to decriminalize euthanasia under certain due-care conditions. Since then, Belgian nurses have been increasingly involved in euthanasia care. In this paper, we report a qualitative study based on in-depth interviews with 18 nurses from Flanders (the Dutch-speaking part of Belgium) who have had experience in caring for patients requesting euthanasia since May 2002 (the approval of the Act). We found that the care (...)
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  • The unhealthy physician.N. Magnavita - 2007 - Journal of Medical Ethics 33 (4):210-214.
    Background: Physicians, if affected by transmissible or impairing diseases, could be hazardous for third persons. Aim: To solve the apparent chasm between patient’s and sick worker’s rights, a consensus-building process leading to hospital-wide policies is the better alternative to individual decision making. Conclusions: Policies have to balance the rights of the sick worker, the right of the other workers, patients and customers, and society’s expectations.
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  • Content analysis of euthanasia policies of nursing homes in Flanders.Joke Lemiengre, Bernadette Dierckx de Casterlé, Yvonne Denier, Paul Schotsmans & Chris Gastmans - 2009 - Medicine, Health Care and Philosophy 12 (3):313-322.
    Objectives To describe the form and content of ethics policies on euthanasia in Flemish nursing homes and to determine the possible influence of religious affiliation on policy content. Methods Content analysis of euthanasia policy documents. Results Of the 737 nursing homes we contacted, 612 (83%) completed and returned the questionnaire. Of 92 (15%) nursing homes that reported to have a euthanasia policy, 85 (92%) provided a copy of their policy. Nursing homes applied the euthanasia law with additional palliative procedures and (...)
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  • Ethics policy review: a case study in quality improvement.Andrea Nadine Frolic & Katherine Drolet - 2013 - Journal of Medical Ethics 39 (2):98-103.
    Policy work is often cited as one of the primary functions of Hospital Ethics Committees (HECs), along with consultation and education. Hospital policies can have far reaching effects on a wide array of stakeholders including, care providers, patients, families, the culture of the organisation and the community at large. In comparison with the wealth of information available about the emerging practice of ethics consultation, relatively little attention has been paid to the policy work of HECs. In this paper, we hope (...)
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  • Uncovering the Real Work Behind Policy Development.Kevin M. Dirksen & Katherine Brown-Saltzman - 2012 - American Journal of Bioethics 12 (11):20-22.
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  • Conscientious refusals to refer: findings from a national physician survey.M. P. Combs, R. M. Antiel, J. C. Tilburt, P. S. Mueller & F. A. Curlin - 2011 - Journal of Medical Ethics 37 (7):397-401.
    Background Regarding controversial medical services, many have argued that if physicians cannot in good conscience provide a legal medical intervention for which a patient is a candidate, they should refer the requesting patient to an accommodating provider. This study examines what US physicians think a doctor is obligated to do when the doctor thinks it would be immoral to provide a referral. Method The authors conducted a cross-sectional survey of a random sample of 2000 US physicians from all specialties. The (...)
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  • Are Ethics Committees in Tune With the “Epidemiology of Ethical Issues”?Rogelio Altisent, Begoña Buil & Maria Teresa Delgado-Marroquín - 2012 - American Journal of Bioethics 12 (11):27-29.
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