Machine learning, artificial intelligence, and other modern statistical methods are providing new opportunities to operationalise previously untapped and rapidly growing sources of data for patient ...benefit. Despite much promising research currently being undertaken, particularly in imaging, the literature as a whole lacks transparency, clear reporting to facilitate replicability, exploration for potential ethical concerns, and clear demonstrations of effectiveness. Among the many reasons why these problems exist, one of the most important (for which we provide a preliminary solution here) is the current lack of best practice guidance specific to machine learning and artificial intelligence. However, we believe that interdisciplinary groups pursuing research and impact projects involving machine learning and artificial intelligence for health would benefit from explicitly addressing a series of questions concerning transparency, reproducibility, ethics, and effectiveness (TREE). The 20 critical questions proposed here provide a framework for research groups to inform the design, conduct, and reporting; for editors and peer reviewers to evaluate contributions to the literature; and for patients, clinicians and policy makers to critically appraise where new findings may deliver patient benefit.
ABSTRACT
Clinical ethics committees have recently been established in nearly all Norwegian hospital trusts. One important task for these committees is clinical ethics consultations. This qualitative ...study explores significant barriers confronting the ethics committees in providing such consultation services. The interviews with the committees indicate that there is a substantial need for clinical ethics support services and, in general, the committee members expressed a great deal of enthusiasm for the committee work. They also reported, however, that tendencies to evade moral disagreement, conflict, and ‘outsiders’ are common in the hospitals. Sometimes even the committees comply with some of these tendencies. The committees agree that there is a need to improve their routines and procedures, clarify the committees' profile and field of responsibility, to make the committees well‐known, to secure adequate operating conditions, and to develop organizational integration and support. Various strategies to meet these challenges on a local, regional or national level are also explored in this paper.
The article advances an understanding of responsible leadership in global business and offers an agenda for future research in this field. Our conceptualization of responsible leadership draws on ...deliberative practices and discursive conflict resolution, combining the macro-view of the business firm as a political actor with the micro-view of leadership. We discuss the concept in relation to existing research in leadership. Further, we propose a new model of responsible leadership that shows how such an understanding of leadership can address the challenges of globalization. We thereby propose positive outcomes of responsible leadership across levels of analysis. The model offers research opportunities for responsible leadership in global business.
The wearable neurotechnology market targets consumers with promises of cognitive benefit and personal wellness. Scientific evidence is essential to substantiate claims about utility, safety, and ...efficacy and for informed choice and public trust.
The wearable neurotechnology market targets consumers with promises of cognitive benefit and personal wellness. Scientific evidence is essential to substantiate claims about utility, safety, and efficacy and for informed choice and public trust.
The dramatic increases of opioid use and misuse in the past 15 years have resulted in a focus on the responsible and judicious use of opioids. In this Ethics Rounds, the commentators analyze the case ...of a 16-year-old girl with lymphoma and opioid misuse whose caregiver may have diverted her opioids. She is now at the end of life and prefers to die at home. The commentators, oncologists, palliative care providers, ethicists, and a medical student agree that supporting the patient's goals and practicing good opioid stewardship are not incompatible. They identify additional information that would be required to analyze the case more fully such as the nature of the evidence for misuse and diversion and whether bias inadvertently contributed to these concerns. They agree that multimodal analgesia, including but not limited to opioids, is important. Safeguards could include a contract, directly observed therapy, and/or urine drug screens. Supervision or removal of a caregiver diverting medication or admission of the patient misusing medications would be alternatives if the initial plan was unsuccessful. Such patient-centered care requires well-developed substance misuse treatment, pain management, and home hospice that are adequately reimbursed.
We build on limited research concerning the mediation processes associated with the relationship between ethical culture and employee outcomes. A multidimensional measure of ethical culture was ...examined for its relationship to overall Person-Organization (P-O) fit and employee response, using a sample of 436 employees from social economy and commercial banks in Spain. In line with previous research involving unidimensional measures, ethical culture was found to relate positively to employee job satisfaction, affective commitment, and intention to stay. New to the literature, ethical culture was also found to be associated positively with employee willingness to recommend the organization to others. These effects were observed even when perceptions of P-O fit were controlled. Importantly, ethical culture was also positively related to overall P-O fit, which in turn, partially mediated the relationship between ethical culture and employee outcomes. Our findings add to studies that focus on the importance of the degree of ethical congruence between the individual employee and the organization. They suggest that ethical culture, with its expected impact on virtuousness and emotional well-being, will positively influence outcomes independently of the degree to which there is a match between employee and organizational values.
hESC research is an ethically acceptable use of human embryos that are in excess of those needed to meet the fertility goals of patients. The ethical basis for this view and issues to be considered ...during the informed consent process for the donation of embryos are developed in this document. This report replaces the Committee's 2009 report, “Donating spare embryos for stem cell research” (Fertil Steril 2009;91:667-70).
This article explores ethical considerations related to participatory visual and digital methods for public health research and practice, through the lens of an approach known as "digital ...storytelling." We begin by briefly describing the digital storytelling process and its applications to public health research and practice. Next, we explore 6 common challenges: fuzzy boundaries, recruitment and consent to participate, power of shaping, representation and harm, confidentiality, and release of materials. We discuss their complexities and offer some considerations for ethical practice. We hope this article serves as a catalyst for expanded dialogue about the need for high standards of integrity and a situated practice of ethics wherein researchers and practitioners reflexively consider ethical decision-making as part of the ongoing work of public health.
Individuals participating in biobanks and other large research projects are increasingly asked to provide broad consent for open-ended research use and widespread sharing of their biosamples and ...data. We assessed willingness to participate in a biobank using different consent and data sharing models, hypothesizing that willingness would be higher under more restrictive scenarios. Perceived benefits, concerns, and information needs were also assessed. In this experimental survey, individuals from 11 US healthcare systems in the Electronic Medical Records and Genomics (eMERGE) Network were randomly allocated to one of three hypothetical scenarios: tiered consent and controlled data sharing; broad consent and controlled data sharing; or broad consent and open data sharing. Of 82,328 eligible individuals, exactly 13,000 (15.8%) completed the survey. Overall, 66% (95% CI: 63%–69%) of population-weighted respondents stated they would be willing to participate in a biobank; willingness and attitudes did not differ between respondents in the three scenarios. Willingness to participate was associated with self-identified white race, higher educational attainment, lower religiosity, perceiving more research benefits, fewer concerns, and fewer information needs. Most (86%, CI: 84%–87%) participants would want to know what would happen if a researcher misused their health information; fewer (51%, CI: 47%–55%) would worry about their privacy. The concern that the use of broad consent and open data sharing could adversely affect participant recruitment is not supported by these findings. Addressing potential participants’ concerns and information needs and building trust and relationships with communities may increase acceptance of broad consent and wide data sharing in biobank research.
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