Article
Ethical principles in guidelines and their evaluation
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Published: | July 10, 2012 |
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Outline
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Background: Bioethical and decision-analytic principles both are guides to medical decision making, which is essential part of health care. Clinical practice guidelines are important strategic tools for medical decision making and bioethical principles should be their integral part. Ethical principles should be explicit in CPGs and have to be systematically evaluated.
Objectives: We have developed an instrument for evaluation of ethical principles in guidelines based on the AGREE II instrument. Ethical issues in CPGs has been discussing within GINETHICS, an informal platform established to share ideas and experiences worldwide.
Methods: The first drafts of the instrument and the User`s guide has been developed, tested followed by the second draft. The questionnaire covers basic ethical principles, i.e. respect for autonomy, beneficence, nonmaleficence and justice, as well as other very important issues such as health professional-patient relationship and interprofessional collaboration. The last question is whether a particular CPG contains examples of ethical dilemmas. The user's manual offers definitions and descriptions of each problem and suggestions where the ethical issues can be found in CPGs. An integral part of the manual will be case reports for each item. The instrument will be disseminated, implemented, evaluated and updated if needed.
Results: Instrument for evaluation of ethical principles in guidelines and pilot version of case reports.
Discussion: Useful instrument for the evaluation of ethical principles in guidelines has been developing.
Implications for guideline developers/users: The instrument can be use during guideline development process as well as during implementation and for evaluation of the quality.