Medicine and Health Sciences Commons^™

Ethical Minefields In Medical Tourism, Katrina Bramstedt

Katrina A. Bramstedt

Extract: Crystal blue waves lapping on the beach and glimmering shopping malls with bargains galore. Would you like a little sun, surf and safari with your surgery, all for a price much less than the surgery alone would cost in the United States? It only takes a few clicks of a computer mouse to find enticing lures bundled with cardiac bypass surgery, vision correction, bariatric surgery, organ transplants, dental implants, and total hip arthroplasty.

Impact Of Consort Extension For Cluster Randomised Trials On Quality Of Reporting And Study Methodology: Review Of Random Sample Of 300 Trials, 2000-8, N. Ivers, M. Taljaard, Stephanie Dixon, C. Bennett, A. Mcrae, J. Taleban, Z. Skea, J. Brehaut, R. Boruch, M. Eccles, J. Grimshaw, Charles Weijer, M. Zwarenstein, A. Donner

Charles Weijer

OBJECTIVE: To assess the impact of the 2004 extension of the CONSORT guidelines on the reporting and methodological quality of cluster randomised trials.

DESIGN: Methodological review of 300 randomly sampled cluster randomised trials. Two reviewers independently abstracted 14 criteria related to quality of reporting and four methodological criteria specific to cluster randomised trials. We compared manuscripts published before CONSORT (2000-4) with those published after CONSORT (2005-8). We also investigated differences by journal impact factor, type of journal, and trial setting.

DATA SOURCES: A validated Medline search strategy. Eligibility criteria for selecting studies Cluster randomised trials published in English language journals, …

Impact Of Consort Extension For Cluster Randomised Trials On Quality Of Reporting And Study Methodology: Review Of Random Sample Of 300 Trials, 2000-8, N. Ivers, M. Taljaard, Stephanie Dixon, C. Bennett, A. Mcrae, J. Taleban, Z. Skea, J. Brehaut, R. Boruch, M. Eccles, J. Grimshaw, Charles Weijer, M. Zwarenstein, A. Donner

Stephanie Dixon

OBJECTIVE: To assess the impact of the 2004 extension of the CONSORT guidelines on the reporting and methodological quality of cluster randomised trials. DESIGN: Methodological review of 300 randomly sampled cluster randomised trials. Two reviewers independently abstracted 14 criteria related to quality of reporting and four methodological criteria specific to cluster randomised trials. We compared manuscripts published before CONSORT (2000-4) with those published after CONSORT (2005-8). We also investigated differences by journal impact factor, type of journal, and trial setting. DATA SOURCES: A validated Medline search strategy. Eligibility criteria for selecting studies Cluster randomised trials published in English language journals, …

When Is Informed Consent Required In Cluster Randomized Trials In Health Research?, Andrew Mcrae, Charles Weijer, Ariella Binik, Jeremy Grimshaw, Robert Boruch, Jamie Brehaut, Allan Donner, Martin P Eccles, Raphael Saginur, Angela White, Monica Taljaard

Charles Weijer

This article is part of a series of papers examining ethical issues in cluster randomized trials (CRTs) in health research. In the introductory paper in this series, we set out six areas of inquiry that must be addressed if the cluster trial is to be set on a firm ethical foundation. This paper addresses the second of the questions posed, namely, from whom, when, and how must informed consent be obtained in CRTs in health research? The ethical principle of respect for persons implies that researchers are generally obligated to obtain the informed consent of research subjects. Aspects of CRT …

Who Is The Research Subject In Cluster Randomized Trials In Health Research?, Andrew Mcrae, Charles Weijer, Ariella Binik, Angela White, Jeremy Grimshaw, Robert Boruch, Jamie Brehaut, Allan Donner, Martin Eccles, Raphael Saginur, Merrick Zwarenstein, Monica Taljaard

Charles Weijer

This article is part of a series of papers examining ethical issues in cluster randomized trials (CRTs) in health research. In the introductory paper in this series, we set out six areas of inquiry that must be addressed if the CRT is to be set on a firm ethical foundation. This paper addresses the first of the questions posed, namely, who is the research subject in a CRT in health research? The identification of human research subjects is logically prior to the application of protections as set out in research ethics and regulation. Aspects of CRT design, including the fact …

A Duty To Warn, An Uncertain Danger / Discussion, Frederic Reamer

Frederic G Reamer

The commitment of confidentiality in the various health and mental health professions is deep-seated. Codes of ethics routinely cite the professional's obligation to hold in confidence information that a client shares. The Code of Ethics of the National Association of Social Workers--which is pertinent to Mrs. D's predicament--is representative: "The social worker should respect the privacy of clients and hold in confidence all information obtained in the course of professional service."

Aids, Social Work, And The "Duty To Protect", Frederic Reamer

Frederic G Reamer

This article discusses social workers' obligation in cases where clients with aquired immune deficiency syndrome (AIDS) pose a threat to a third party. Emphasis is on cases where a client diagnosed with AIDS withholds that information from a sexual partner. Legal and ethical issues concerning the limits of confidentiality and the social worker's "duty to protect" third parties are reviewed. Relevant case law and emerging ethical standards in various professions are summarized. The author reviews legal precedents concerning disclosure of confidential information without a client's permission and discusses their relevance to AIDS cases. Implications and guidelines for social workers are …

Aids And Ethics, Frederic Reamer

Frederic G Reamer

The seriousness of the AIDS crisis is well known. Since the first case was documented in Los Angeles in 1981, the media have been filled with research updates, documentaries, and exposes on the dreaded disorder. Reports and case studies have ranged from informative to sensational. They have included serious academic studies, educational overviews targeted for the general public, and columns in weekly tabliods.

Aids And Social Work, Frederic Reamer

Frederic G Reamer

Social workers are becoming increasingly involved in casework and social policy debate related to the acquired immune deficiency syndrome (AIDS) crisis. To enhance their delivery of services and contribution to policy formulation, social workers need to be familiar with a wide range of ethical and civil liberties issues that have been generated by the AIDS epidemic. This article provides an overview of six major ethical and civil liberties issues pertaining to social work practice related to AIDS: (1) mandatory screening and testing of clients for the immunodeficiency virus (HIV), (2) client access to health insurance, (3) professionals' duty to treat …

Minimal Risk Remains An Open Question, Ariella Binik, Charles Weijer, Mark Sheehan

Charles Weijer

No abstract provided.

Inadequate Reporting Of Research Ethics Review And Informed Consent In Cluster Randomised Trials: Review Of Random Sample Of Published Trials, Monica Taljaard, Andrew Mcrae, Charles Weijer, Carol Bennett, Stephanie Dixon, Julia Taleban, Zoe Skea, Martin P Eccles, Jamie Brehaut, Allan Donner, Raphael Saginur, Robert Boruch, Jeremy Grimshaw

Charles Weijer

OBJECTIVES: To investigate the extent to which authors of cluster randomised trials adhered to two basic requirements of the World Medical Association's Declaration of Helsinki and the International Committee of Medical Journal Editors' uniform requirements for manuscripts (namely, reporting of research ethics review and informed consent), to determine whether the adequacy of reporting has improved over time, and to identify characteristics of cluster randomised trials associated with reporting of ethics practices.

DESIGN: Review of a random sample of published cluster randomised trials from an electronic search in Medline.

SETTING: Cluster randomised trials in health research published in English language journals …

Does Clinical Equipoise Apply To Cluster Randomized Trials In Health Research?, Ariella Binik, Charles Weijer, Andrew Mcrae, Jeremy Grimshaw, Robert Boruch, Jamie Brehaut, Allan Donner, Martin Eccles, Raphael Saginur, Monica Taljaard, Merrick Zwarenstein

Charles Weijer

This article is part of a series of papers examining ethical issues in cluster randomized trials (CRTs) in health research. In the introductory paper in this series, Weijer and colleagues set out six areas of inquiry that must be addressed if the cluster trial is to be set on a firm ethical foundation. This paper addresses the third of the questions posed, namely, does clinical equipoise apply to CRTs in health research? The ethical principle of beneficence is the moral obligation not to harm needlessly and, when possible, to promote the welfare of research subjects. Two related ethical problems have …

Inadequate Reporting Of Research Ethics Review And Informed Consent In Cluster Randomised Trials: Review Of Random Sample Of Published Trials, Monica Taljaard, Andrew Mcrae, Charles Weijer, Carol Bennett, Stephanie Dixon, Julia Taleban, Zoe Skea, Martin P Eccles, Jamie Brehaut, Allan Donner, Raphael Saginur, Robert Boruch, Jeremy Grimshaw

Stephanie Dixon

OBJECTIVES: To investigate the extent to which authors of cluster randomised trials adhered to two basic requirements of the World Medical Association's Declaration of Helsinki and the International Committee of Medical Journal Editors' uniform requirements for manuscripts (namely, reporting of research ethics review and informed consent), to determine whether the adequacy of reporting has improved over time, and to identify characteristics of cluster randomised trials associated with reporting of ethics practices. DESIGN: Review of a random sample of published cluster randomised trials from an electronic search in Medline. SETTING: Cluster randomised trials in health research published in English language journals …

Ethical Issues Posed By Cluster Randomized Trials In Health Research, Charles Weijer, Jeremy Grimshaw, Monica Taljaard, Ariella Binik, Robert Boruch, Jamie Brehaut, Allan Donner, Martin Eccles, Antonio Gallo, Andrew Mcrae, Raphael Saginur, Merrick Zwarenstein

Charles Weijer

The cluster randomized trial (CRT) is used increasingly in knowledge translation research, quality improvement research, community based intervention studies, public health research, and research in developing countries. However, cluster trials raise difficult ethical issues that challenge researchers, research ethics committees, regulators, and sponsors as they seek to fulfill responsibly their respective roles. Our project will provide a systematic analysis of the ethics of cluster trials. Here we have outlined a series of six areas of inquiry that must be addressed if the cluster trial is to be set on a firm ethical foundation: 1. Who is a research subject? 2. …

Of Mice But Not Men: Problems Of The Randomized Clinical Trial, Samuel Hellman, Deborah Hellman

Deborah Hellman

No abstract provided.