BMC MEDICAL ETHICS 是一本开放获取期刊，发表与生物医学研究和临床实践的伦理方面相关的原始同行评审研究文章，包括专业选择和行为、医疗技术、医疗保健系统和卫生政策。

BMC Medical Ethics is an open-access journal that focuses on ethical issues related to biomedical research and clinical practice. It publishes original peer-reviewed research articles covering topics such as professional choices and behaviors, medical technologies, healthcare systems, and health policies.

BMC Medical Ethics 是一本开放获取的期刊，专注于生物医学研究和临床实践中的伦理问题。期刊发表经过同行评审的原创研究文章，内容涵盖专业选择与行为、医疗技术、医疗保健系统及卫生政策等领域。

BMC Medical Ethics

The impetus for policies promoting medical data sharing in China has gained significant traction. Nonetheless, the present legal and ethical framework governing the research use of medical data in China, is characterized by a more restrictive rather than permissive approach. The proportion of Chinese medical data being leveraged for scientific research still has room for improvement at present, indicating a significant untapped potential for advancing medical knowledge and improving healthcare outcomes. Building upon this research, we aim to delve deeper into the challenges researchers encounter in the sharing of medical data through focus group interviews. We conducted two focus group interviews study with researchers representing diverse disciplines to explore their perspectives on 21 June 2021 and 28 July 2021. A total of seventeen researchers willingly participated in this study, representing various professional backgrounds. Similar codes were merged. Research team discussions were also utilized to select interviewees' statements that were regarded as typical or representative. The respondents demonstrated a strong understanding that medical data should not be disseminated arbitrarily, recognizing the importance of sharing data in compliance with laws. Through the interview, we found that although respondents stressed the importance of careful consideration regarding if and when this information can be responsibly released, none of the respondents raised the issue of necessitating consent from data subjects for the research use of medical data. This observation sharply contrasts with the stringent separate consent provisions for secondary data use outlined in the PIPL. The findings from the focus group studies shed light on researchers' barriers and ethical challenges towards medical data sharing for scientific research, highlighting their deep concern for data security and cautious approach to sharing. The key objectives aimed at facilitating and enabling the reuse of medical data encompass enhancing interoperability, harmonizing data standards, improving data quality, safeguarding privacy, ensuring informed consent, incentivizing patients, and establishing explicit regulations pertaining to data access and utilization.

Xiaojie Li

Yali Cong

Exploring barriers and ethical challenges to medical data sharing: perspectives from Chinese researchers

探索医疗数据共享的障碍与伦理挑战：来自中国研究人员的观点

When including participants with dementia in research, various ethical issues arise. At present, there are only a few existing dementia-specific research guidelines (Committee for Medicinal Products for Human Use in Clinical investigation of medicines for the treatment Alzheimer's disease (Internet). https://www.ema.europa.eu/en/clinical-investigation-medicines-treatment-alzheimers-disease ; Food and Drug Administration, Early Alzheimer's Disease: Developing Drugs for Treatment Guidance for Industry [Internet]. http://www.fda.gov/regulatory-information/search-fda-guidance-documents/alzheimers-disease-developing-drugs-treatment-guidance-industy ), necessitating a more systematic and comprehensive approach to this topic to help researchers and stakeholders address dementia-specific ethical issues in research. A systematic literature review provides information on the ethical issues in dementia-related research and might therefore serve as a basis to improve the ethical conduct of this research. This systematic review aims to provide a broad and unbiased overview of ethical issues in dementia research by reviewing, analysing, and coding the latest literature on the topic.

Tim G. Götzelmann

Daniel Strech

Hannes Kahrass

The full spectrum of ethical issues in dementia research: findings of a systematic qualitative review

痴呆症研究中的全谱伦理问题：一项系统定性综述的发现

Conscientious objection poses ethical dilemmas frequently encountered by nurses, allowing them to prioritize personal beliefs in caregiving. However, it may also be viewed as a stance jeopardizing patients' healthcare access. There is no measurement tool to measure conscientious objection in nurses. This study aimed to develop a measurement tool for nurses' conscientious objection attitudes. This research is a methodological study conducted with a total of 261 nurses in Turkiye. Following content validity assessments by ten experts, a 29-item draft scale was developed. Exploratory and confirmatory factor analyses examined the factor structure, and reliability was assessed via the Spearman-Brown coefficient, intraclass correlation coefficient (ICC), and Bland Altman plot. Cronbach's alpha estimated internal consistency and discrimination, which were evaluated by comparing lower and upper 27% groups. The Nurses' Conscientious Objection Attitude Scale (COAS-N) comprises 29 items and three sub-dimensions (prioritizing professional values, prioritizing personal values, and requesting the right to conscientious objection). Cronbach's alpha for the entire scale is 0.81. Validity and reliability were established for the newly developed scale measuring nurses' conscientious objection attitudes.

Seyhan Demir Karabulut

Şenay Gül

Eylem Gül Ateş

Zehra Göçmen Baykara

Development, reliability, and validity of the nurses’ conscientious objection attitude scale (COAS-N)

护士良心拒绝态度量表（COAS-N）的编制、信度与效度研究

Considering the importance of complying medical and general ethics and the lack of a study on determining ethical considerations in the communication network of women undergoing hysterectomy surgery, this study aimed to present these aspects in the patients' lives by a standard researcher-made instrument. This mixed method analysis (exploratory sequential mixed methods design was conducted in the whole of 2020 to create the "ethical considerations in communication network of women undergone hysterectomy" questionnaire and investigate its psychometric properties. A researched-made instrument was validated and its psychometric properties were checked among 218 women by confirmatory factor analysis (CFA). Accordingly, the 8 factors extracted included "complying ethical consideration by the physician (a)", "complying ethical consideration by medical team (b)", "complying ethical consideration in the hospital (c)", "complying ethical consideration by the secretory in the clinic (d)", "complying ethical consideration by the spouse (e)", and "complying ethical consideration by the family and friends (f)", "complying ethical consideration by the media and society (g)" and "complying ethical consideration by herself (h)". The results of Cronbach's alpha test showed that there is moderate to good internal consistency in all dimensions. Cronbach's alpha for the whole questionnaire was calculated as 0.75, which shows that the internal consistency is at a good level. According to the results of this study, the reliability (internal consistency) and construct validity of the ethical considerations in the communication network of women undergoing hysterectomy questionnaire were confirmed. However, in light of the study limitations, caution should be practiced in the interpretation of the results. There is a need for further longitudinal studies in multiple settings using random sampling methods.

Elahe Bahador

Laleh Tajadiny

Abolfazl Hossein Nataj

Masumeh Ghazanfarpour

Azam Zare Arashlouei

Atefeh Ahmadi

Fahimeh Khorasani

Mina Mobasher

Jaleh Tajadini

Investigating ethical considerations in the communication network of married women undergone hysterectomy: instrumentation of a questionnaire

探讨已婚女性子宫切除术后沟通网络中的伦理考量：问卷工具的编制

Abstract Background The scrutiny surrounding gender-affirming medical treatment (GAMT) for youth has increased, particularly concerning the limited evidence on long-term treatment outcomes. The Standards of Care 8 by the World Professional Association for Transgender Health addresses this by outlining research evidence suggesting “effective” outcomes of GAMT for adolescents. However, claims concerning what are considered “effective” outcomes of GAMT for adolescents remain implicit, requiring further reflection. Methods Using trans negativity as a theoretical lens, we conducted a theory-informed reflexive thematic analysis of the literature cited in the “Research Evidence” section of the SOC8 Adolescents chapter. We selected 16 articles that used quantitative measures to assess GAMT outcomes for youth, examining how “effective” outcomes were framed and interpreted to uncover implicit and explicit normative assumptions within the evidence base. Results A total of 44 different measures were used to assess GAMT outcomes for youth, covering physical, psychological, and psychosocial constructs. We identified four main themes regarding the normative assumptions of “effective” treatment outcomes: (1) doing bad: experiencing distress before GAMT , (2) moving toward a static gender identity and binary presentation , (3) doing better: overall improvement after GAMT , and (4) the absence of regret . These themes reveal implicit norms about what GAMT for youth should achieve, with improvement being the benchmark for “effectiveness.” Discussion We critically reflect on these themes through the lens of trans negativity to challenge what constitutes “effective” GAMT outcomes for youth. We explore how improvement justifies GAMT for youth and address the limitations of this notion. Conclusions We emphasize the need for an explicit discussion on the objectives of GAMT for adolescents. The linear narrative of improvement in GAMT for adolescents is limited and fails to capture the complexity of GAMT experiences. With currently no consensus on how the “effectiveness” of GAMT for adolescents is assessed, this article calls for participatory action research that centers the voices of young TGD individuals.

Ezra D. Oosthoek

Skye Stanwich

Karl Gerritse

David Matthew Doyle

Annelou L.C. de Vries

Gender-affirming medical treatment for adolescents: a critical reflection on “effective” treatment outcomes

青少年性别确认医疗：对“有效”治疗结果的批判性反思

The primary objective of this study was to conduct a comprehensive questionnaire survey on the practices of research ethics committees reviewing academic research projects in Czechia. The study aims to provide an unbiased and objective assessment of the current practices of research ethics committees, namely to obtain the missing data on their functioning in the context of academic research, to identify difficulties and shortages that threaten the responsible functioning of research ethics committees in the country and to investigate the implementation of Additional Protocol on Biomedical Research CETS No. 195 in their practice. Such research has never been conducted in Czechia. This was a mixed-methods study, in which the online survey with closed and open-ended questions was chosen to explore the situation regarding ethics assessment of research involving human participants. We developed a questionnaire containing 18 questions concerning several aspects of the functioning of research ethics committees. The questionnaire was in Czech language and was administered through the Qualtrics platform anonymously. The target group of 61 research ethics committees at research institutions was approached by emails and we received 43 completely filled questionnaires, i.e., response rate of 67%. We obtained valuable data on the functioning of research ethics committees in Czechia in three main domains: the mandate and composition of the committee; the scope of its agenda; the process of evaluation including the voting procedure. In addition, the final set of open-ended questions provided an in-depth look at the problems faced by research ethics committees in Czechia. From the results is evident that the responsible assessment of the ethics of research involving human subjects is still not satisfactorily addressed and established for routine practice in the country. The outcomes of our study revealed that the main problem of research ethics in Czechia is the lack of national legislation on research ethics governance. To address this problem, the country requires a legislative framework accompanied by supportive measures aimed at educating, guiding and advising research ethics committees, especially in the Czech academic environment. Not applicable.

Renata Veselska

Jan Sirucek

Josef Kure

Survey on the current practice of research ethics committees in the Czech academic environment: a mixed-methods study

捷克学术环境中研究伦理委员会当前实践的调查：一项混合方法研究

Health equity matters, but there is no universally accepted definition of this or associated terms, such as inequities, inequalities, and disparities. Given the flexibility of these terms, investigating how policymakers understand them is important to observe priorities and perhaps course correct. Accordingly, this study analyzed the perceptions high-level policymakers within the WHO African Region. An online survey was distributed to attendees of the WHO's Fifth Health Sector Directors' Policy and Planning Meeting for the WHO African Region by email. After responses were collected, both inductive and deductive coding were applied. Inductive coding was undertaken to glean central concepts from free-form responses on understandings of health equity and deductive coding was used to assess alignment with four theories of distributive justice using a coding framework. In analyzing central concepts, three became apparent: access to health services and/or health care, financial protection, and recognizing subgroups. And when we investigated alignment with theory, most respondents' understandings of health equity aligned with Rawls' 'Theory of Justice' (95%). Of these responses, 70% were exclusively aligned with Rawls' 'Theory of Justice' and 30% aligned also with another theory (this 30% was split 55% utilitarianism and 45% Sen's Capabilities Approach). Respondent understandings of health equity showed limited alignment with other theories of distributive justice, which were: utilitarianism (n = 7/39; 17.95%), Sen's Capabilities Approach (n = 5/39; 12.82%), and libertarianism (n = 2/39; 5.13%). Our study demonstrates that alignment with certain theories is tied to specific themes (i.e., theoretical underpinnings may guide policymakers to favour certain policy approaches). For instance, a utilitarian-minded policymaker may be focused on a widespread vaccination campaign, whereas a Rawlsian-aligned policymaker may focus on a targeted approach to reach communities that have lower vaccination rates, and a Senian-aligned policymaker may focus on health literacy programs targeted at addressing vaccine-hesitant individuals within communities with lower vaccination rates. These findings can guide high-level policymakers and international organizations to optimize decision-making by clarifying ethical alternatives.

Michelle Amri

Borgar Jølstad

Jesse B. Bump

Health equity and distributive justice: views of high-level African policymakers

健康公平与分配正义：非洲高层政策制定者的观点

Abbreviation	BMC Med. Ethics
Journal Impact	3.19
Quartiles(Global)	SOCIAL SCIENCES, BIOMEDICAL(Q1)

ISSN	1472-6939
h-index	60
Top Journals	Yes

Publication Information	Publisher: BioMed Central Ltd，Publishing cycle: Irregular，Journal Type: journal，Open Access Journals: Yes
Basic data	Year of publication: 2000，Proportion of original research papers: 94.16%，Self Citation Rate:6.70%， Gold OA Rate: 100.00%
Journal Fees	$2090Details
Average review cycle	网友分享经验：>12周，或约稿
Average recruitment ratio	网友分享经验：较易

BMC Medical Ethics

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Exploring barriers and ethical challenges to medical data sharing: perspectives from Chinese researchers

The full spectrum of ethical issues in dementia research: findings of a systematic qualitative review

Development, reliability, and validity of the nurses’ conscientious objection attitude scale (COAS-N)

Investigating ethical considerations in the communication network of married women undergone hysterectomy: instrumentation of a questionnaire

Gender-affirming medical treatment for adolescents: a critical reflection on “effective” treatment outcomes

Survey on the current practice of research ethics committees in the Czech academic environment: a mixed-methods study

Health equity and distributive justice: views of high-level African policymakers

Development, reliability, and validity of the nurses’ conscientious objection attitude scale (COAS-N)