Ethical Dimensions in Contemporary Medical Practices: A Systematic Review and Analysis of Diverse Perspectives

Material and Method

The involved scientific protocol to conduct this systematic analysis is summarized as following.

Protocol and Registration

This analysis adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines 2020 (15). Review Manager (RevMen 5.4) was utilized for quantitative data analysis to identify the array of ethical dimensions in medical practices.

Eligibility Criteria

This exploration delved into scholarly articles focusing on ethical considerations within modern medical practices, spanning the years [2020, 2021, 2022, 2023]. The selected articles, obtained from reputable sources such as Sci-hub, web of science, Scopus, PubMed, and Google Scholar, represented viewpoints from diverse stakeholders. These contributions elucidated established ethical frameworks or introduced innovative approaches, contributing significantly to the ongoing dialogue on ethical conduct in current medical care. Exclusion criteria ensured a thorough exploration by omitting pieces lacking empirical basis or incongruent with the contemporary scope of this review.

Information Sources, Search Strategy and Selection Process

A database of research articles was created using specific Medical Subject Headings (MeSH) terms in major databases (PubMed, Scopus, Web of Knowledge, and Google Scholar) related to medical ethics, professional practices, family practices, and medical practices. The author performed study selection based on title, abstract, and full-text evaluations.

Data Collection Process and Data Items

Selected research studies were evaluated based on titles and abstracts, followed by a detailed examination of full-text articles. Data extraction was performed frequency, percentage, thematically and verbatim and compiled in a Microsoft Excel Sheet.

Risk of Bias Assessment among Studies

The risk of bias within individual studies was assessed following Cochrane Collaboration ROB-2 guidelines, evaluating biases related to random sequence generation, blinding, incomplete outcome data, and selective reporting.

Additional Analysis and Risk of Bias across Studies

Additional analysis sheets were prepared to assess characteristics such as research design, study settings, interventions, and outcomes of individual studies. The risk of bias was categorized as low, unclear, or high and presented through graphs.

Study Selection

In the quest to explore the ethical dimensions within modern medical practices, a systematic process was adopted to identify, assess, and include pertinent studies. This endeavor commenced by scouring databases, yielding a substantial pool of 297 records, and tapping into registers, adding an additional 100 records to the mix. These records underwent a meticulous screening process: initially, 147 records were evaluated, and among them, 25 duplicates were promptly removed to ensure uniqueness. Automated tools flagged 75 records as unsuitable based on predefined criteria, while an additional 50 records were excluded due to various reasons unrelated to the study’s scope. Furthermore, 50 reports could not be retrieved for further scrutiny. The ones that did undergo assessment-100 reports in total-underwent a stringent evaluation for eligibility. Ultimately, from this thorough screening, 15 studies emerged as fitting the criteria and were included in the review. Among these studies, 11 reports were generated, encapsulating the essence of the included studies, setting the stage for an in-depth analysis of the ethical intricacies within contemporary medical practices. This stringent process aimed to ensure that only the most relevant and fitting studies were incorporated, maintaining the integrity and precision of the exploration into ethical considerations in today’s medical landscape.

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Study Characteristics

The systematic review analysis encompasses a range of studies within the realm of medical ethics, each delving into distinct aspects of healthcare practices and ethical considerations. In an effort to unravel the intricate ethical dimensions surrounding parental decision-making for adolescents with mental health issues, Bieber, et al. undertook a case report analysis [6]. The study offered a nuanced exploration of parental capacity challenges, shedding light on the ethical complexities of overriding parental decisions. However, the limitation lies in the case report’s inherent narrow focus, hindering the generalizability of its findings. Moreover, the absence of a specific sample size diminishes the precision of the study’s conclusions [6]. Liddell, et al. embarked on a legal analysis journey, aiming to unravel the complexities of isolating residents in care and group homes during the COVID-19 pandemic. While the study successfully explored isolation strategies and ethical considerations, its limitations emerge from the lack of specific case details and a potential bias towards legal aspects (Table 1). The focus on legalities may overshadow a comprehensive understanding of the ethical implications [7].

In an innovative approach to medical ethics education, Chen, et al. engaged fourth-year medical students in a mixed methods study. The study, involving 135 participants, sought to evaluate the effectiveness of a new curriculum. While the mixed methods design adds depth to the findings, self-reporting bias and reliance on student perceptions introduce subjectivity. The lack of specific data on training outcomes further limits the study’s depth [8]. Exploring the intersection of medicine, law, ethics, and economics, El- Khoury, et al. conducted a narrative review on the legalization of medical cannabis in Lebanon. The study illuminated the symbolic nature of the law, presenting a tapestry of mixed reactions and concerns over implementation. However, the lack of specific data on outcomes and the subjective nature of the narrative review introduce potential biases, limiting the study’s robustness [9].

In the midst of the first COVID-19 surge, Erler, et al. undertook a retrospective cohort mixed methods study to dissect the ethical issues in patient care. Identifying themes related to prognostic difficulty, challenges in visitor restrictions, and end-of-life scenarios, and the study provides practical insights. Nevertheless, the lack of a significant difference in consultation cases and reliance on retrospective data may constrain the generalizability of the findings [10]. Venturing into the controversial terrain of medical aid in dying, Kious BM conducted a philosophical evaluation of the impact of injustice on hard choices. The study offers theoretical insights into the ethical considerations surrounding medical aid in dying. Yet, the subjective evaluation of hard choices and the absence of specific data on actual cases may limit the practical application of the study’s findings [11]. Addressing the imperative of research ethics training, a study involving postgraduate medical students in India adopted an intervention approach. Integrating interactive lectures and small group teaching, the study aimed to enhance the effectiveness of research ethics training. However, the lack of specific data on training outcomes and the reliance on self- reported measures introduce potential biases, leaving room for a more comprehensive assessment.

In the diverse landscape of medical ethics, Zahedi, et al. engaged in a qualitative content analysis, seeking to unravel the ideas and experiences of academic faculties in Iran regarding common morality in a pluralistic setting. The study, though rich in insights related to ontology and epistemology of common morality, faces limitations in generalizability due to a small sample size and the subjective nature of qualitative analysis [1]. Navigating the evolving landscape of cannabis legalization, Towobola, et al. conducted a narrative review on the impact of legalization and decriminalization on risks, ethics, and support for pregnant women using cannabis. The study highlighted increased cannabis use trends and unmitigated risks in pregnancy. However, the lack of specific guidance for clinicians and the need for more research may limit the practical application of the study’s findings [5]. In the realm of medical education, Ting, et al. embarked on a scoping review to explore the evidence-guided approach to portfolio-guided teaching and assessing effectiveness. The study contributes to the understanding of effective teaching methods in the domains of communications, ethics, and professionalism [12]. However, the lack of specific outcomes data and reliance on existing literature may limit the depth of the study.