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Ursin F, Müller R, Funer F, Liedtke W, Renz D, Wiertz S, Ranisch R. Non-empirical methods for ethics research on digital technologies in medicine, health care and public health: a systematic journal review. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2024:10.1007/s11019-024-10222-x. [PMID: 39120780 DOI: 10.1007/s11019-024-10222-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/27/2024] [Indexed: 08/10/2024]
Abstract
Bioethics has developed approaches to address ethical issues in health care, similar to how technology ethics provides guidelines for ethical research on artificial intelligence, big data, and robotic applications. As these digital technologies are increasingly used in medicine, health care and public health, thus, it is plausible that the approaches of technology ethics have influenced bioethical research. Similar to the "empirical turn" in bioethics, which led to intense debates about appropriate moral theories, ethical frameworks and meta-ethics due to the increased use of empirical methodologies from social sciences, the proliferation of health-related subtypes of technology ethics might have a comparable impact on current bioethical research. This systematic journal review analyses the reporting of ethical frameworks and non-empirical methods in argument-based research articles on digital technologies in medicine, health care and public health that have been published in high-impact bioethics journals. We focus on articles reporting non-empirical research in original contributions. Our aim is to describe currently used methods for the ethical analysis of ethical issues regarding the application of digital technologies in medicine, health care and public health. We confine our analysis to non-empirical methods because empirical methods have been well-researched elsewhere. Finally, we discuss our findings against the background of established methods for health technology assessment, the lack of a typology for non-empirical methods as well as conceptual and methodical change in bioethics. Our descriptive results may serve as a starting point for reflecting on whether current ethical frameworks and non-empirical methods are appropriate to research ethical issues deriving from the application of digital technologies in medicine, health care and public health.
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Affiliation(s)
- Frank Ursin
- Institute for Ethics, History and Philosophy of Medicine, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.
| | - Regina Müller
- Institute of Philosophy, University of Bremen, Enrique-Schmidt-Straße 7, 28359, Bremen, Germany
| | - Florian Funer
- Institute for Ethics and History of Medicine, Eberhard Karls University, Gartenstrasse 47, 72074, Tübingen, Tübingen, Germany
| | - Wenke Liedtke
- Faculty of Theology, University of Greifswald, Am Rubenowplatz 2-3, 17489, Greifswald, Germany
| | - David Renz
- Faculty of Protestant Theology, University of Bonn, Am Hofgarten 8, 53113, Bonn, Germany
| | - Svenja Wiertz
- Department of Medical Ethics and the History of Medicine, University of Freiburg, Stefan-Meier-Str. 26, 79104, Freiburg, Germany
| | - Robert Ranisch
- Junior Professorship for Medical Ethics with a Focus on Digitization, Faculty of Health Sciences Brandenburg, University of Potsdam, Am Mühlenberg 9, 14476, Potsdam, Golm, Germany
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Nobile H, Moshtaghin NLR, Lüddecke Z, Schnarr A, Mertz M. What can the citations of systematic reviews of ethical literature tell us about their use?-an explorative empirical analysis of 31 reviews. Syst Rev 2023; 12:173. [PMID: 37740244 PMCID: PMC10517474 DOI: 10.1186/s13643-023-02341-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 09/01/2023] [Indexed: 09/24/2023] Open
Abstract
Background Systematic reviews of ethical literature (SREL) aim at providing an overview of ethical issues, arguments, or concepts on a specific ethical topic. As SREL are becoming more common, their methodology and possible impact are increasingly subjected to critical considerations. Because they analyse and synthetise normative literature, SREL are likely to be used differently than typical systematic reviews. Still, the uses and the expected purposes of SREL were, to date, mainly theoretically discussed. Our explorative study aimed at gaining preliminary empirical insights into the actual uses of SREL. Methods Citations of SREL in publications, both scientific and non-scientific, were taken as proxy for SREL uses. The citations of 31 published SREL were systematically searched on Google Scholar. Each citation was qualitatively analysed to determine its function. The resulting categorisation of SREL citations was further quantitatively investigated to unveil possible trends. Results The analysis of the resulting sample of SREL citations (n=1812) showed that the selected SREL were mostly cited to support claims about ethical issues, arguments, or concepts, but also to merely mention the existence of literature on a given topic. In this sample, SREL were cited predominantly within empirical publications in journals from various academic fields, indicating a broad, field-independent use of such systematic reviews. The selected SREL were also used as methodological orientations either for the conduct of SREL or for the practical and ethically sensitive conduct of empirical studies. Conclusions In our sample, SREL were rarely used to develop guidelines or to derive ethical recommendations, as it is often postulated in the theoretical literature. The findings of this study constitute a valuable preliminary empirical input in the current methodological debate on SREL and could contribute to developing strategies to align expected purposes with actual uses of SREL. Supplementary Information The online version contains supplementary material available at 10.1186/s13643-023-02341-y.
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Affiliation(s)
- Hélène Nobile
- Institute for Ethics, History and Philosophy of Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - Natali Lilie Randjbar Moshtaghin
- Institute for Ethics, History and Philosophy of Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Zoë Lüddecke
- Institute for the History of Medicine and Medical Ethics, Faculty of Medicine and University Hospital, University of Cologne, Joseph-Stelzmann-Str. 20, Geb. 42, 50931, Cologne, Germany
| | - Antje Schnarr
- Institute for Ethics, History and Philosophy of Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Marcel Mertz
- Institute for Ethics, History and Philosophy of Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
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Horton J, DeJean D, Farrah K, Hodgson A, Kaunelis D, Walter M. Ethics information retrieval in HTA: state of current practice. Int J Technol Assess Health Care 2023; 39:e43. [PMID: 37465961 DOI: 10.1017/s0266462323000247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
OBJECTIVES Though there have been longstanding discussions on the value of ethics in health technology assessment (HTA), less awareness exists on ethics information retrieval methods. This study aimed to scope available evidence and determine current practices for ethics information retrieval in HTA. METHODS Literature searches were conducted in Ovid MEDLINE, LISTA, Scopus, and Google Scholar. Once a list of relevant articles was determined, citation tracking was conducted via Scopus. HTA agency websites were searched for published guidance on ethics searching, and for reports which included ethical analyses. Methods sections of each report were analyzed to determine the databases, subject headings, and keywords used in search strategies. The team also reached out to information specialists for insight into current search practices. RESULTS Findings from this study indicate that there is still little published guidance from HTA agencies, few HTAs that contain substantial ethical analysis, and even less information on the methodology for ethics information retrieval. The researchers identified twenty-five relevant HTAs. Ten of these reports did not utilize subject-specific databases outside health sciences. Eight reports published ethics searches, with significant overlap in subject headings and text words. CONCLUSIONS This scoping study of current practice in HTA ethics information retrieval highlights findings of previous studies-while ethics analysis plays a crucial role in HTA, methods for literature searching remain relatively unclear. These findings provide insight into the current state of ethics searching, and will inform continued work on filter development, database selection, and grey literature searching.
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Affiliation(s)
- Jennifer Horton
- Canadian Agency for Drugs and Technologies in Health, Ottawa, ON, Canada
| | - Deirdre DeJean
- Canadian Agency for Drugs and Technologies in Health, Ottawa, ON, Canada
| | - Kelly Farrah
- Canadian Agency for Drugs and Technologies in Health, Ottawa, ON, Canada
| | - Amanda Hodgson
- Canadian Agency for Drugs and Technologies in Health, Ottawa, ON, Canada
| | - David Kaunelis
- Canadian Agency for Drugs and Technologies in Health, Ottawa, ON, Canada
| | - Melissa Walter
- Canadian Agency for Drugs and Technologies in Health, Ottawa, ON, Canada
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Mann SP, Treit PV, Geyer PE, Omenn GS, Mann M. Ethical Principles, Constraints and Opportunities in Clinical Proteomics. Mol Cell Proteomics 2021; 20:100046. [PMID: 33453411 PMCID: PMC7950205 DOI: 10.1016/j.mcpro.2021.100046] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 01/04/2021] [Indexed: 12/11/2022] Open
Abstract
Recent advances in mass spectrometry (MS)-based proteomics have vastly increased the quality and scope of biological information that can be derived from human samples. These advances have rendered current workflows increasingly applicable in biomedical and clinical contexts. As proteomics is poised to take an important role in the clinic, associated ethical responsibilities increase in tandem with impacts on the health, privacy, and wellbeing of individuals. We conducted and here report a systematic literature review of ethical issues in clinical proteomics. We add our perspectives from a background of bioethics, the results of our accompanying paper extracting individual-sensitive results from patient samples, and the literature addressing similar issues in genomics. The spectrum of potential issues ranges from patient re-identification to incidental findings of clinical significance. The latter can be divided into actionable and unactionable findings. Some of these have the potential to be employed in discriminatory or privacy-infringing ways. However, incidental findings may also have great positive potential. A plasma proteome profile, for instance, could inform on the general health or disease status of an individual regardless of the narrow diagnostic question that prompted it. We suggest that early discussion of ethical issues in clinical proteomics can ensure that eventual healthcare practices and regulations reflect the considered judgment of the community and anticipate opportunities and problems that may arise as the technology matures.
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Affiliation(s)
- Sebastian Porsdam Mann
- Department of Media, Cognition and Communication, University of Copenhagen, Copenhagen, Denmark; Uehiro Center for Practical Ethics, University of Oxford, Oxford, UK; New address: Faculty of Law, University of Oxford, Oxford, UK.
| | - Peter V Treit
- Department of Proteomics and Signal Transduction, Max Planck Institute of Biochemistry, Martinsried, Germany
| | - Philipp E Geyer
- Department of Proteomics and Signal Transduction, Max Planck Institute of Biochemistry, Martinsried, Germany; NNF Center for Protein Research, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark; New address: OmicEra Diagnostics GmbH, Planegg, Germany
| | - Gilbert S Omenn
- Departments of Computational Medicine & Bioinformatics, Internal Medicine, Human Genetics, and School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Matthias Mann
- Department of Proteomics and Signal Transduction, Max Planck Institute of Biochemistry, Martinsried, Germany; NNF Center for Protein Research, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
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