Jonathan Ives

• BA, M.Phil, PhD, PGCert LTHE
• Professor at University of Bristol

This article discusses men's transition to first time fatherhood, with a focus on the way they recognise various in-tension moral demands and negotiate an appropriate role for themselves. The findings are taken from a longitudinal study, drawing on elements of grounded theory, comprising a series of face-to-face and telephone interviews with 11 men...

In this paper we argue that there are few morally acceptable justifications for a man to seek a paternity test. The relationship between material responsibility and the burdens generated by the creation of a needy child, means it is not unreasonable for a man to establish that he is responsible for the creation of a child before accepting this fina...

In the UK, putative fathers are encouraged to be involved in antenatal and maternal health care, in the belief that involving men as early as possible lays the foundation for better, more involved fatherhood. Integrating men into maternity care can, however, have hitherto unexplored ethical complexities. We begin by providing three ethical justific...

In recent years there has been a wealth of literature arguing the need for empirical and interdisciplinary approaches to bioethics, based on the premise that an empirically informed ethical analysis is more grounded, contextually sensitive and therefore more relevant to clinical practice than an ‘abstract’ philosophical analysis. Bioethics has (arg...

In this paper we set forth what we believe to be a relatively controversial argument, claiming that 'bioethics' needs to undergo a fundamental change in the way it is practised. This change, we argue, requires philosophical bioethicists to adopt reflexive practices when applying their analyses in public forums, acknowledging openly that bioethics i...

Much has been written about the need for trustworthy artificial intelligence (AI), but the underlying meaning of trust and trustworthiness can vary or be used in confusing ways. It is not always clear whether individuals are speaking of a technology’s trustworthiness, a developer’s trustworthiness, or simply of gaining the trust of users by any mea...

Background Reducing ‘avoidable’ hospital admissions towards the end of life and facilitating death at home have had considerable attention in the literature. The role of a Primary Care clinician is central to many of these decisions and should be closely examined if we are to consider how current processes may be improved. Decision making in signif...

Testicular transplantation to restore fertility in males—who is it for? Fertility preservation in young males is a well-recognized area of clinical need. Currently, for males who are unable to produce viable sperm, there are no proven clinical options to father their own biological child (Mulder et al., 2021). Cryopreservation of testicular tissue...

Background Systematic reviews (SR) are well elaborated and established for synthesizing statistical information, for example of clinical studies, for determining whether a clinical intervention is effective. SRs are also becoming more and more popular in bioethics. However, the established approach of conducting and reporting cannot be transferred...

Engagement with genomic medicine and research has increased globally during the past few decades, including rapid developments in Sri Lanka. Genomic research is carried out in Sri Lanka on a variety of scales and with different aims and perspectives. However, there are concerns about participants' understanding of genomic research, including the va...

Artificially intelligent systems (AISs) are being created by software developing companies (SDCs) to influence clinical decision‐making. Historically, clinicians have led healthcare decision‐making, and the introduction of AISs makes SDCs novel actors in the clinical decision‐making space. Although these AISs are intended to influence a clinician's...

In the context of a cancer diagnosis, fertility preservation interventions are used to mitigate the potential impact of gonadotoxic cancer treatment upon fertility. They provide patients with cancer the option to freeze their reproductive material to have their own biological child following treatment. The evidence suggests some clinicians are less...

With the introduction of artificial intelligence (AI) to healthcare, there is also a need for professional guidance to support its use. New (2022) reports from National Health Service AI Lab & Health Education England focus on healthcare workers’ understanding and confidence in AI clinical decision support systems (AI-CDDSs), and are concerned with...

Soft robotics is an emerging technology in which engineers create flexible devices for use in a variety of applications. In order to advance the wide adoption of soft robots, ensuring their trustworthiness is essential; if soft robots are not trusted, they will not be used to their full potential. In order to demonstrate trustworthiness, a specific...

Background Recruitment to intrapartum research is complex. Women are expected to understand unfamiliar terminology and assess potential harm versus benefit to their baby and themselves, often when an urgent intervention is required. Time pressures of intrapartum interventions are a major challenge for recruitment discussions taking place during lab...

In this chapter, we seek to offer a fresh perspective on whether or not doctors should be “licensed to kill”. As that phrase indicates, we metaphorically refer to the adventures of fictional spy James Bond, although we hope, in doing so, that readers will not think that we are belittling the serious topic with which the chapter is concerned. Having...

In this chapter, we will explore various ways in which open education resources might be utilised in the teaching of medical humanities in medical schools. Open education resources are generic open access materials in a particular field, which can be used by educators and students alike to support teaching and learning. They might be particularly u...

Background Recruitment to intrapartum research is complex. Women are expected to understand unfamiliar terminology and assess potential harm versus benefit to their baby and themselves, often when an urgent intervention is required. Time pressures of intrapartum interventions are a major challenge for recruitment discussions taking place during lab...

Responsible research and innovation (RRI) aims to achieve the goal of making research activities responsible and ethical. To those ends, it is vital for researchers to actively engage with equality, diversity and inclusion (EDI) which, if not attended to, may detrimentally affect both potential research participants and the research itself. Our pap...

Nanomedicine refers to medical products developed using nanotechnology and has the potential to radically change how we diagnose and treat cancer. While the use of nanomedicines has increased in the clinic dramatically, problems persist over the lack of an agreed definition, creating difficulties for safety (including toxicity profiles), governance...

Background Outcomes for neonatal intestinal failure (IF) have improved significantly over the past two decades, however, there is no consensus for decision making among UK paediatric subspecialists. Objectives The aim was to describe clinician’s attitudes to decision making in neonatal IF and examine variation between subspecialties. Methods Neon...

Importance: Patient-reported outcomes (PROs) can inform health care decisions, regulatory decisions, and health care policy. They also can be used for audit/benchmarking and monitoring symptoms to provide timely care tailored to individual needs. However, several ethical issues have been raised in relation to PRO use. Objective: To develop inter...

Attempts to conduct systematic reviews of ethical arguments in bioethics are fundamentally misguided. All areas of enquiry need thorough and informative literature reviews, and efforts to bring transparency and systematic methods to bioethics are to be welcomed. Nevertheless, the raw materials of bioethical articles are not suited to methods of sys...

Background Ubiquitous, smart technology has the potential to assist humans in numerous ways, including with health and social care. COVID-19 has notably hastened the move to remotely delivering many health services. A variety of stakeholders are involved in the process of developing technology. Where stakeholders are research participants, this pos...

NEW VERSION: https://www.researchgate.net/publication/376547229_RESERVE_-_REporting_of_SystEmatic_ReViews_in_Ethics_development_explanations_and_examples. | Old Abstract: Systematic reviews (SR) are very well elaborated and established for synthesizing statistical information, for example of clinical studies, for determining whether a clinical inte...

Background Auditory Verbal Hallucinations (AVH) are a hallmark of psychosis, but affect many other clinical populations. Patients’ understanding and self-management of AVH may differ between diagnostic groups, change over time, and influence clinical outcomes. This study aimed to explore patients’ understanding and self-management of AVH in a young...

Aims and objectives: To explore moral distress empirically and conceptually, to understand the factors that mitigate and exacerbate moral distress and construct a model that represents how moral distress relates to its constituent parts and related concepts. Background: There is ongoing debate about how to understand and respond to moral distres...

Our article aims to provide a comprehensive portrayal of how seven Asian jurisdictions have sought to address the challenge of genetic discrimination (GD) by presenting an analysis of the relevant legislation, policies, and practices. Based on our findings, policy discussion and action on preventing or mitigating GD have been narrowly framed in ter...

Background During the arrival of the COVID-19 pandemic, various professional ethical guidance was issued to (and for) health and social care professionals in England and Wales. Guidance can help to inform and support such professionals and their patients, clients and service users, but a plethora of guidance risked information overload, confusion,...

Aims Auditory Verbal Hallucinations (AVH) are a hallmark of psychosis, but affect many other clinical populations. Patients’ understanding and self-management of AVH may differ between diagnostic groups, change over time, and influence clinical outcomes. We aimed to explore patients’ understanding and self-management of AVH in a young adult clinica...

Introduction The post-2005 rise in clinical trials and clinical research conducted in India was accompanied by frequent reports of unethical practices, leading to a series of regulatory changes. We conducted a systematic scoping review to obtain an overview of empirical research pertaining to the ethics of clinical trials/research in India. Method...

When providing care, nephrologists are subject to various ethical duties. Beyond the Hippocratic notion of doing no harm, nephrologists also have duties to respect their patients’ autonomy and dignity, to meet their patients’ care goals in the least invasive way, to act impartially, and, ultimately, to do what is (clinically) beneficial for their p...

Lack of vaccine confidence can contribute to drops in vaccination coverage and subsequent outbreaks of diseases like measles and polio. Low trust in vaccines is attributed to a combination of factors, including lack of understanding, vaccine scares, flawed policies, social media and mistrust of vaccine manufacturers, scientists and decision-makers....

Background Chronic kidney disease is a significant cause of global deaths. Those who progress to end-stage kidney disease often commence dialysis as a life-extending treatment. For cognitively impaired patients, the decision as to whether they commence dialysis will fall to someone else. This scoping review was conducted to map existing literature...

This paper adds to an increasing body of social science literature, which engages with the research practice of "co-production." It aims to make a distinctive contribution by suggesting that what is produced under this process should be given greater attention. Previous literature has focused on the "co" (cooperative) element: debating whether and...

BACKGROUND Ubiquitous , smart technology has the potential to assist humans in numerous ways, including with health and social care. COVID-19 has notably hastened the move to remotely delivering many health services. A variety of stakeholders are involved in the process of developing technology. Where stakeholders are research participants, this po...

Introduction General Practitioners (GPs) and allied healthcare professionals working in primary care are regularly required to make decisions with, for and on behalf of patients who lack capacity. In England and Wales, these decisions are made for incapacitated adult patients under the Mental Capacity Act 2005, which primarily requires that decisio...

Objective To explore the phenomenology of auditory verbal hallucinations (AVHs) in a clinical sample of young people who have a ‘non-psychotic’ diagnosis. Methods Ten participants aged 17–31 years with presentation of emotionally unstable personality disorder or post-traumatic stress disorder and frequent AVHs were recruited and participated in a...

There has been increasing debate in recent years about the conceptualization of moral distress. Broadly speaking, two groups of scholars have emerged: those who agree with Jameton’s ‘narrow definition’ that focuses on constraint and those who argue that Jameton’s definition is insufficient and needs to be broadened. Using feminist empirical bioethi...

Whilst debate continues regarding how to define moral distress (MD), one constant has been the belief that healthcare professionals often experience MD during end-of-life (EoL) care. In this chapter, we will discuss the concept of MD in the context of EoL care, drawing on a recent case that has attracted global attention and empirical data drawn fr...

Pandemic carries ethical challenges for surgeons

Improving surgical interventions is key to improving outcomes. Ensuring the safe and transparent translation of such improvements is essential. Evaluation and governance initiatives, including the IDEAL framework and the Macquarie Surgical Innovation Identification Tool have begun to address this. Yet without a definition of innovation that allows...

Background: There is growing interest in the use and incorporation of empirical data in bioethics research. Much of the recent focus has been on specific "empirical bioethics" methodologies, which attempt to integrate the empirical and the normative. Researchers in the field are, however, beginning to explore broader questions, including around ac...

Introduction Worldwide, 10%–20% of children and adolescents experience mental health conditions. However, most such disorders remain undiagnosed until adolescence or adulthood. Little is known about the factors that influence mental health in children and adolescents, especially in low and middle-income countries (LMIC), where environmental threats...

Background The phenomenon of ‘moral distress’ has continued to be a popular topic for nursing research. However, much of the scholarship has lacked conceptual clarity, and there is debate about what it means to experience moral distress. Moral distress remains an obscure concept to many clinical nurses, especially those outside of North America, an...

Austerity, by its very nature, imposes constraints by limiting the options for action available to us because certain courses of action are too costly or insufficiently cost effective. In the context of healthcare, the constraints imposed by austerity come in various forms; ranging from the availability of certain treatments being reduced or withdr...

This paper responds to the commentaries from Stacy Carter and Alan Cribb. We pick up on two main themes in our response. First, we reflect on how the process of setting standards for empirical bioethics research entails drawing boundaries around what research counts as empirical bioethics research, and we discuss whether the standards agreed in the...

Background Genomic research allows new discoveries to alleviate human suffering but in turn raises significant ethical issues. In this context, public acceptance and engagement is a major determinant of optimization of genomic research. Therefore, understanding public perspectives related to genomic research is imperative, as it provides a foundati...

Background: This paper reports the process and outcome of a consensus finding project, which began with a meeting at the Brocher Foundation in May 2015. The project sought to generate and reach consensus on standards of practice for Empirical Bioethics research. The project involved 16 academics from 5 different European Countries, with a range of...

This chapter offers a reflection on some of the interconnected philosophical, ethical and methodological challenges that have arisen in the research on fatherhood and in response to scholarly engagements with fatherhood research. The case for research funding may be easier to make if the proposed research addresses a clear area of need and/or addre...

This book offers unique insights into how to research fathers and fatherhood in contemporary society. Outlining research methods in detail, including examples of large-scale studies, online research, surveys and visual and aural methods, the book explores how each approach worked in practice, what the benefits and pitfalls were, and what the wider...

This paper argues that the convention of allocating donated gametes on a ‘first come, first served’ basis should be replaced with an allocation system that takes into account more morally relevant criteria than waiting time. This conclusion was developed using an empirical bioethics methodology, which involved a study of the views of 18 staff membe...

Aims The aim of this narrative synthesis was to explore the necessary and sufficient conditions required to define moral distress. Background Moral distress is said to occur when one has made a moral judgement but is unable to act upon it. However, problems with this narrow conception have led to multiple redefinitions in the empirical and concept...

In 2014, the editorial board of BMC Medical Ethics came together to devise sections for the journal that would (a) give structure to the journal (b) help ensure that authors' research is matched to the most appropriate editors and (c) help readers to find the research most relevant to them. The editorial board decided to take a practical approach t...

Research exploring parents’ experiences of having offspring with autism spectrum disorder (ASD) currently underrepresents fathers. This study aimed to develop an understanding of the experience of fathers, with a view to facilitating improved support. Eight fathers participated in semi-structured interviews exploring their experiences of fathering...

Bioethics has long been accepted as an interdisciplinary field. The recent 'empirical turn' in bioethics is however, creating challenges that move beyond those of simple interdisciplinary collaboration, as researchers grapple with the methodological, empirical and meta-ethical challenges of combining the normative and the empirical, as well as navi...

Background Withdrawal of treatment is a common practice in intensive care units when treatment is considered futile. Compassion is an important aspect of care; however, it has not been explored much within the context of treatment withdrawal in intensive care units. Objectives The aim was to examine how concepts of compassion are framed, utilised...

Bioethics has long been accepted as an interdisciplinary field. The recent 'empirical turn' in bioethics is however, creating challenges that move beyond those of simple interdisciplinary collaboration, as researchers grapple with the methodological, empirical and meta-ethical challenges of combining the normative and the empirical, as well as navi...

Bioethics has long been accepted as an interdisciplinary field. The recent 'empirical turn' in bioethics is however, creating challenges that move beyond those of simple interdisciplinary collaboration, as researchers grapple with the methodological, empirical and meta-ethical challenges of combining the normative and the empirical, as well as navi...

Objectives Patient-reported outcome measures (PROMs) collected in clinical trials should be administered in a standardised way across sites and routinely screened for avoidable missing data in order to maximise data quality/minimise risk of bias. Recent qualitative findings, however, have raised concerns about the consistency of PROM administration...

Background An empirical bioethics analysis exploring what palliative inpatients understand as compassion was planned within an Intercalated BMedSc degree. Limited time was available, so to achieve deadlines, a co-developmental approach was employed maximising clinical/research expertise from hospice and university. Aim To study compassion by formi...

Background As agency and capacity decline towards the end of life, compassion becomes an increasingly important and apposite feature of healthcare. Whilst more compassionate healthcare is being called for, especially in end of life contexts, there is relatively little understanding of what compassion actually is, or how it can be enacted. Aim To c...

In “A Conceptual Model for the Translation of Bioethics Research and Scholarship,” Debra Mathews et al. aim to “begin an important discussion” about how to measure success in bioethics, and in doing so they set out a typology of bioethics research and scholarship with the arguably correct assumption that we cannot evaluate success in bioethics with...

Background In dimensional understanding of psychosis, auditory verbal hallucinations (AVH) are unitary phenomena present on a continuum from non-clinical voice hearing to severe mental illness. There is mixed evidence for this approach and a relative absence of research into subjective experience of AVH in early psychosis. Aims To conduct primary...

Background: Assessment of patient-reported outcomes (PROs) provides valuable information to inform patient-centered care, but may also reveal 'PRO alerts': psychological distress or physical symptoms that may require an immediate response. Ad-hoc management of PRO alerts in clinical trials may result in suboptimal patient care or potentially bias...

Survey Instruments. (PDF)

Survey Dataset. (XLSX)

Objective: Auditory verbal hallucinations (AVHs) are core features of psychotic illness and remain significant in predicting poor outcome and risk. There has been a wide range of approaches to understanding these experiences. Method: A systematic literature review summarizing different methods of investigation and their results; phenomenology, d...

In this chapter, we seek to offer a fresh perspective on whether or not doctors should be “licensed to kill”. As that phrase indicates, we metaphorically refer to the adventures of fictional spy James Bond, although we hope, in doing so, that readers will not think that we are belittling the serious topic with which the chapter is concerned. Having...

Conditional and directed deceased organ donations occur when donors (or often their next of kin) attempt to influence the allocation of their donated organs. This can include asking that the organs are given to or withheld from certain types of people, or that they are given to specified individuals. Donations of these types have raised ethical con...

This editorial begins, perhaps unusually, with a personal anecdote from Ives, one of the editors of this special edition, which sets the scene for the edition and, to some extent, explains why the debates presented in these pages are needed:When I was first starting out as a Ph.D. student in 2004, I submitted a paper to a philosophy journal that di...

Background Despite the increased prevalence of bioethics research that seeks to use empirical data to answer normative research questions, there is no consensus as to what an appropriate methodology for this would be. This review aims to search the literature, present and critically discuss published Empirical Bioethics methodologies. Methods MedL...

Introduction Evidence suggests that the subjective experience of AVHs cannot be explained by any of the existing cognitive models,[1] highlighting the obvious need to properly investigate the actual, lived experience of AVHs, and derive models/theories that fit the complexity of this. Objectives Via phenomenological interviews and ethnographic dia...

The Interdisciplinary and Empirical Ethics Network was established in 2012 with funding from the Wellcome Trust in order to facilitate critical and constructive discussion around the nature of the disciplinary diversity within bioethics and to consider the ongoing development of bioethics as an evolving field of interdisciplinary study. In April 20...

Evidence suggests there are inconsistencies in patient-reported outcome (PRO) assessment and reporting in clinical trials, which may limit the use of these data to inform patient care. For trials with a PRO endpoint, routine inclusion of key PRO information in the protocol may help improve trial conduct and the reporting and appraisal of PRO result...

Qualitative evidence suggests patient-reported outcome (PRO) information is frequently absent from clinical trial protocols, potentially leading to inconsistent PRO data collection and risking bias. Direct evidence regarding PRO trial protocol content is lacking. The aim of this study was to systematically evaluate the PRO-specific content of UK Na...