Lucy Frith

Lucy Frith
The University of Manchester · Centre for Social Ethics and Policy

PhD

About

145
Publications
30,037
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Introduction
Lucy Frith works at the University of Manchester, in the Centre for Social Ethics & Policy. Her research sits at the interface of bioethics and socio-legal studies, with a particular interest in combining empirical methods with ethical analysis. She has an expertise in empirical ethics, qualitative research methods and public patient involvement. She is currently working on projects on reproductive technologies and family relationships, and Reset Ethics https://www.liverpool.ac.uk/law/research/

Publications

Publications (145)
Article
McCoy et al. (2020) give a finely tuned analysis of the role and responsibilities of non-elected or self-appointed representatives in public policy. They take the example of autism activism to illustrate the debate over who can credibly act as a representative of this population and what responsibilities such a role might entail. Non-elected repres...
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What does the reality of COVID-19 say about bioethics as a discipline, or the role of bioethicists in society? Why are so many ‘pandemic ethics’ plans or triage heuristics being suddenly thrown together? Is it a problem that multiple conflicting proposals for how to allocate scarce resources (eg, ventilators) are being published on an almost daily...
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Study question: What information and support should be offered to donors, intended parents and donor-conceived people, in general and in consideration of the availability of direct-to-consumer genetic testing and matching services? Summary answer: For donors, intended parents and donor-conceived offspring, recommendations are made that cover inf...
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Objective To identify ethical values guiding decision making in resetting non-COVID-19 paediatric surgery and maternity services in the National Health Service (NHS). Design A rapid review of academic and grey literature sources from 29 April to 31 December 2020, covering non-urgent, non-COVID-19 healthcare. Sources were thematically synthesised a...
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Background The national health care response to coronavirus (COVID-19) has varied between countries. The United Kingdom (UK) and the Netherlands (NL) have comparable maternity and neonatal care systems, and experienced similar numbers of COVID-19 infections, but had different organisational responses to the pandemic. Understanding why and how simil...
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Choice is probably one of the most often discussed areas in bioethics, alongside the related concepts of informed consent and autonomy. It is generally, prima facie, portrayed as a good thing. In healthcare, the 2000s saw the UK Prime Minister Tony Blair pursue the ‘Choice Agenda’ where, ‘As capacity expands, so choice will grow. Choice will fundam...
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This paper examines a legal case arising from a workplace grievance that progressed to being heard at the UK’s Supreme Court. The case of Doogan and Wood versus Greater Glasgow and Clyde Health Board concerned two senior midwives in Scotland, both practicing Roman Catholics, who exercised their perceived rights in accordance with section 4(1) of th...
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Objective Clinical trials and studies in intensive care units (ICUs) have complex consent processes and often encounter problems in recruiting patients. By interviewing research team members about the challenges in critical care research, we aimed to identify strategies to enhance recruitment and consent to ICU studies. Methods Semistructured inte...
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text The growth in the use of direct-to-consumer-genetic testing (DTCGT) is having a major impact on sperm, egg and embryo donor conception (hereafter donor conception). DTCGT services include family history sites, e.g. Ancestry.com, and medical testing sites, e.g.23andme. Despite the many different motivations people have for using these services,...
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We have been researching the distinctive ethical issues raised by what we have called “the reset period,” when non-Covid services resumed alongside the continuing pandemic in the UK. In this commentary, we will first consider the similarities and differences between the reset and contingency phases, as described by Alfandre et al. We will then unpa...
Article
Community engagement (CE) contributes to successful research. There is, however, a lack of literature on the effectiveness of different models of CE and, specifically, on CE strategies for the conduct of genomic research in sub‐Saharan Africa. There is also a need for models of CE that transcend the recruitment stage of engaging prospective individ...
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Introduction Big data research has grown considerably over the last two decades. This presents new ethical challenges around consent, data storage and anonymisation. Big data research projects require public support to succeed and it has been argued that one way to achieve this is through public involvement and engagement. To better understand the...
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There are a growing, number of tips, how to guides and suggestions for PPIE in health and social care research remotely (NIHR School for Primary Care Research, BC Support Unit for example). We will conduct a rapid review of this growing area to identify key gaps to be filled and identify good practice. We will search websites and online resources f...
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Expanded carrier screening (ECS) entails a screening offer for carrier status for multiple recessive disorders simultaneously and allows testing of couples or individuals regardless of ancestry or geographic origin. Although universal ECS—referring to a screening offer for the general population—has generated considerable ethical debate, little att...
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COVID-19 continues to dominate 2020 and is likely to be a feature of our lives for some time to come. Given this, how should health systems respond ethically to the persistent challenges of responding to the ongoing impact of the pandemic? Relatedly, what ethical values should underpin the resetting of health services after the initial wave, knowin...
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Full-text available
Choice is probably one of the most often discussed areas in bioethics, alongside the related concepts of informed consent and autonomy. It is generally, prima facie, portrayed as a good thing. In healthcare, the 2000s saw the UK Prime Minister Tony Blair pursue the ‘Choice Agenda’ where, ‘As capacity expands, so choice will grow. Choice will fundam...
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Full-text available
Population-level biomedical research offers new opportunities to improve population health, but also raises new challenges to traditional systems of research governance and ethical oversight. Partly in response to these challenges, various models of public involvement in research are being introduced. Yet, the ways in which public involvement shoul...
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STUDY QUESTION What is the recommended management for women and transgender men with regards to fertility preservation (FP), based on the best available evidence in the literature? SUMMARY ANSWER The ESHRE Guideline on Female Fertility Preservation makes 78 recommendations on organization of care, information provision and support, pre-FP assessme...
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This paper advances the case for a ‘sociology of donation’. We aim to establish that there is a need for such a sociology, to bring together the many, often disparate, elements that make up the theorizing, practice and experience of donation. We argue that bringing together different forms of donation illuminates the distinctive place both in socia...
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In 2014, the EU funded a four-year European Cooperation in Science and Technology (COST) Action to address the topic of childbirth. The COST Birth Action was a cross-European network, that brought together over 120 scientists, practitioners, activists and policy makers from 34 countries to work on intrapartum care. The central aim was to advance th...
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Newborn bloodspot screening for cystic fibrosis is a valid public health strategy for populations with a high incidence of this inherited condition. There are a wide variety of approaches to screening and in this paper, we propose that a bioethical framework is required to determine the most appropriate screening protocol for a population. This fra...
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Background Variations in intervention rates, without subsequent reductions in adverse outcomes, can indicate overuse. We studied variations in and associations between commonly used childbirth interventions and adverse outcomes, adjusted for population characteristics. Methods and findings In this multinational cross-sectional study, existing data...
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This qualitative study examines researchers' views of research ethics in everyday global mental health research practice. We present data from a multi-site study conducted in 2014-15 involving 35 individual in-depth interviews that explore researchers' perceptions of procedural ethics in research conducted in South Asia. We examine how researchers'...
Chapter
This article reports on a systematic review of all (19) English language research reports published in peer-reviewed journals up to 2011 exploring donor-conceived people’s experiences and perceptions of donor conception. Most research concerned individuals conceived through sperm donation conducted under a regime promoting anonymity and nondisclosu...
Article
Background Clinical commissioning involves ethically challenging decisions about health resource allocation. However, commissioners come from a range of professional backgrounds with varying levels of training and expertise in ethical decision-making. Hence, they may lack the relevant training and resources to feel fully prepared for this increasin...
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In their paper Horton et al argue that it is acceptable to contact an anonymous egg-donor to facilitate diagnostic genetic testing for the donor conceived child, despite the donor, ‘indicating on a historical consent form that she did not wish to take part in future research, and that she did not wish to be informed if she was found to be a carrier...
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Objectives The Royal College of Physician’s (RCP) Future Hospital Programme (FHP) set out a blueprint for a radical new model of care that put patient experience centre stage. This paper reports on the results of an independent evaluation of the FHP and focuses on the role public patient involvement (PPI) played in these projects. The paper explore...
Article
This article discusses when it is ethically acceptable to withdraw consent for the storage and use of embryos and gametes. Currently, the law in the UK states that consent to use of a gamete or embryo can be withdrawn up to the point of the embryo's transfer to the recipient's uterus or when the gamete is used in providing treatment services; that...
Article
Rapid developments in technology have continued to extend possibilities for isolating and exchanging body parts, marking donation as an increasingly significant practice in the 21st century. In recent years we have witnessed heightened political and sociological interest in the donation of body parts and products, such as organs, gametes and embryo...
Article
In recent years, following the improved prognosis of patients with cancer, interest and attention has grown around fertility issues in these patients. International guidelines on fertility preservation in patients with cancer recommend that physicians discuss with all patients of reproductive age (or their parents/guardians, if children) the risk o...
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Given increasing globalisation, the continuing prevalence of emergencies, and the importance of rigorous research to ensure the mental health needs of populations exposed to emergencies are effectively met, cross-language research will continue to arise. Drawing upon the lead author’s experience of conducting a cross-language qualitative study in t...
Article
Achieving the objectives of rolling out genomic research programs in sub-Saharan Africa depends on how prepared indigenous biomedical researchers are for this type of research. We explored the level of preparedness of biomedical researchers in a sub-Saharan African country using in-depth interviews to obtain data on their understanding of genomics...
Conference Paper
Background There is a move, internationally, towards greater integration of health and social care. Integration, it is argued, should reduce budgetary boundaries and facilitate sharing of resources across health and social care. At local levels, delivery organisations need to alter the balance of care from acute settings to people’s own home or sim...
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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...
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The following information is missing from the Funding and Acknowledgements sections: Professor Mark Gabbay and Dr Lucy Frith are part-funded by The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care North West Coast (NIHR CLAHRC NWC). The views expressed here are those of the author(s) and not ne...
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Objectives We explored children’s views on research without prior consent (RWPC) and sought to identify ways of involving children in research discussions. Design Qualitative interview study. Setting Participants were recruited through a UK children’s hospital and online advertising. Participants 16 children aged 7–15 years with a diagnosis of a...
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Background: Freedom of conscience is a core element of human rights respected by most European countries. It allows abortion through the inclusion of a conscience clause, which permits opting out of providing such services. However, the grounds for invoking conscientious objection lack clarity. Our aim in this paper is to take a step in this direc...
Chapter
The moral status of the fetus is one of the most contested areas of bioethics debate, and prolife and prochoice positions on abortion have polarised US politics in the modern era (Wison, 2012). I will argue that there are two apparently contradictory views of the fetus: the ‘disposable fetus’ of prenatal testing and the ‘protected fetus’ of the per...
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Objective As genomic research gathers momentum in sub-Saharan Africa, it has become increasingly important to understand the reasons why individuals wish to participate in this kind of medical research. Against the background of communitarianism conceived as typical of African communities, it is often suggested that individuals consent to participa...
Data
Word cloud for youth FG participants. (DOCX)
Data
Word cloud for adult FG participants. (DOCX)
Article
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This document is designed to give guidance on assessing researchers in bioethics/medical ethics. It is intended to assist members of selection, confirmation and promotion committees, who are required to assess those conducting bioethics research when they are not from a similar disciplinary background. It does not attempt to give guidance on the qu...
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Purpose: Recognising that one way to address the logistical and safety considerations of research conducted in humanitarian emergencies is to use internet communication technologies to facilitate interviews online, this article explores some practical and methodological considerations inherent to qualitative online interviewing. Method: Reflecti...
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This paper considers the experiences of adults conceived following sperm donation, who were registered with a voluntary DNA linking register and considers: how awareness of being donor-conceived affected their identity and family relationships; and the process of searching for their donor and donor-conceived siblings. The views and experiences of d...
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Introduction There are growing concerns about the increase in rates of commonly used childbirth interventions. When indicated, childbirth interventions are crucial for preventing maternal and perinatal morbidity and mortality, but their routine use in healthy women and children leads to avoidable maternal and neonatal harm. Establishing ideal rates...
Article
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Background: Research in emergencies is needed to understand the prevalence of mental health and psychosocial problems and strengthen the evidence base for interventions. All research - including operational needs assessments, programme monitoring and evaluation, and formal academic research - must be conducted ethically. While there is broad conse...
Article
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This article considers the disclosure, sharing and exchange of information on being donor conceived within families, drawing on data from a study undertaken with donor-conceived adults registered with UK Donor Link (a voluntary DNA-linking register). This paper considers the narratives of how respondents found out they were donor-conceived and what...
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O19 Developing resources for a learner-centred approach to learning and development for public involvement in research Lucy Frith1, Bernard Gudgin2, Amander Wellings3 1National Institute for Health Research (NIHR), Research Design Service North West, University of Liverpool, Liverpool, UK; 2Public representative, Thames Valley, UK; 3Public represe...
Poster
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A collaboration of five clinical commissioning groups (CCGs) was surveyed to assess ethical training received and what commissioners perceived as ethics educational needs.
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This paper presents the Protocol for a multicentre study that seeks to analyse the relationship between midwife care during childbirth and spontaneous vaginal birth. Each participating hospital collects outcome data from a sample of all women birthing, determined according to the number of annual births attended by midwives, in each hospital. Data...
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It has been demonstrated that many common obstetric practices such as rupture of membranes for induction of labour, routine intrapartum amniotomy, continuous electronic foetal heart-rate monitoring or routine continuous infusion of intravenous fluids and oxytocin augmentation, are of limited benefit 5-6. The range of and variation in the use of int...
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This article presents a case study on the organization of maternity health care in Switzerland. Switzerland has a costly health care system with high intervention rates within an obstetric-led maternity care model. Evidence has shown that midwifery care is associated with lower cost, higher satisfaction rates among women, and less intervention. How...
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Background Depression and debt are common in the UK. Debt Counselling for Depression in Primary Care: an adaptive randomised controlled pilot trial (DeCoDer) aimed to assess the clinical effectiveness and cost-effectiveness of the addition of a primary care debt counselling advice service to usual care for patients with depression and debt. However...
Poster
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What do children and young people (CYP) think about research without prior consent in critical care situations?
Poster
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To explore children and young peoples’ experience of living with acute and chronic illness, and the potential impact of frequent emergency department admissions upon their daily lives and well-being
Conference Paper
Aims Variations from informed consent (known as deferred consent or research without prior consent-RWPC) enable paediatric critical care research to proceed by allowing consent to be sought after a child has received an investigational intervention. The first UK trials conducted in this setting show high levels of recruitment, yet children and youn...
Article
Objectives: Measuring of antenatal care utilisation is important from a public health perspective. The Content and Timing of care in Pregnancy tool (CTP) focuses on the care process and includes aspects on quality of care. The aim of the study is to gain insight in the applicability of the CTP tool across Europe. Methods: National guidelines for...
Article
Study question: What contact arrangements are established between providers and recipients of embryos using Snowflakes® Embryo Adoption Program? Summary answer: Contact arrangements varied considerably and were generally positively described, although some challenges were acknowledged. What is known already: Reproductive technologies create ne...
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This paper reports on a study of the views and experiences of 21 sperm donors and five egg donors registered with UK DonorLink (UKDL), a voluntary DNA-based contact register established to facilitate contact between adults who wish to identify and locate others to whom they are genetically related following donor conception. Specifically, the paper...
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Medical science has enabled the creation of families through the use of donor conception but some lifelong policy and practice implications are only recently being recognized. Research and practice have shown that donor conception can, for some, carry substantial long-term consequences. In this paper we present findings from a questionnaire-based s...
Chapter
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There is an increasing demand for gestational surrogacy in current reproductive medicine practice. Infertile couples often engage overseas surrogates, which increases the risk for legal and ethical complications. This book provides clinical guidance on the provision of gestational surrogacy on a worldwide basis, with brief summaries of the legal po...
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Introduction: One significant change in the English National Health Service (NHS) has been the introduction of market mechanisms. This review will explore the following questions: should we have markets in healthcare? What is the underlying philosophy of introducing more market mechanisms into the NHS? What are the effects of this and does it chan...
Article
Background: Media framing can influence people’s perceptions of social changes in family building, and has the potential to influence their future actions. Objectives: to analyse the type of framing and construction used in British newsprint of transnational commercial surrogacy. Methods: UK newspapers were searched using the search engine Lexis-Ne...