Samia A Hurst

• MD
• Professor (Associate) at University of Geneva

Objectives To identified the core components of professional ethics for medical sign language interpreters and develop a framework based on empirical data from Colombian sign language (CSL) interpreters. Design Purposive and snowball sampling methods were used in this qualitative study, which involved conducting semistructured interviews to CSL in...

UNSTRUCTURED The immediate context in which a person lives shapes their experience of impairment and disability. Assistive technology (AT) tools are the interface between impairment and context. This article presents a new framework for the design of assistive technology. It provides a theoretical exploration of the relationship between context, as...

Background Informed consent is one of the key principles of conducting research involving humans. When research participants give consent, they perform an act in which they utter, write or otherwise provide an authorisation to somebody to do something. This paper proposes a new understanding of the informed consent as a compositional act. This conc...

Despite scientific and technological advances in the field of assistive technology (AT) for people with visual impairment (VI), technological designs are frequently based on a poor understanding of the physical and social context of use, resulting in devices that are less than optimal for their intended beneficiaries. To resolve this situation, use...

Background: Children and adolescents are highly vulnerable to the impact of sustained stressors during developmentally sensitive times. We investigated how demographic characteristics intersect with socioeconomic dimensions to shape the social patterning of quality of life and mental health in children and adolescents, two years into the COVID-19...

Applying equity to health care is difficult and it is especially challenging when applied to cases that involve urgent military medicine care under resource scarcity. Part of the difficulty centers on the concept of equity itself. It is not clear what the best concept of equity applicable to medical care would be, or that there should be only one,...

Background Existential suffering is often a part of the requests for assisted suicide (AS). Its definitions have gained in clarity recently and refer to a distress arising from an inner realization that life has lost its meaning. There is however a lack of consensus on how to manage existential suffering, especially in a country where AS is legal a...

Despite cardiopulmonary resuscitation (CPR) and do-not-attempt-resuscitation (DNAR) decisions are increasingly considered an essential component of hospital practice and patient inclusion in these conversations an ethical imperative in most cases, there is evidence that such discussions between physicians and patients/surrogate decision-makers (the...

Despite scientific and technological advances in the field of assistive technology (AT) for people with visual impairment (VI), technological designs are frequently based on a poor understanding of the physical and social context of use, resulting in devices that are less than optimal for their intended beneficiaries. To resolve this situation, use...

Observational population studies indicate that prevention of dementia and cognitive decline is being accomplished, possibly as an unintended result of better vascular prevention and healthier lifestyles. Population aging in the coming decades requires deliberate efforts to further decrease its prevalence and societal burden. Increasing evidence sup...

Background: The medium-term impact of the COVID-19 pandemic on the wellbeing of children and adolescents remains unclear. More than 2 years into the pandemic, we aimed to quantify the frequency and determinants of having been severely impacted by the COVID-19 pandemic and estimate its impact on health-related quality of life (HRQoL) and mental hea...

The objective of this study was to investigate reasons for or against anonymity that are pertinent to kidney paired donations (KPD). We conducted a systematic review of reasons using PubMed and Google Scholar until May 2022 and through snowballing. Inclusion criteria were publications that: 1) discussed organ donation anonymity; 2) was peer-reviewe...

Introduction Constantly rising costs of pharmaceuticals and biologics spurred a debate in recent years leading to increasingly persistent public calls to overhaul the existing system of pricing and distributing health technologies. The COVID-19 pandemic exposed the controversies of the current model of access to health commodities in all evidence w...

There are concerns about acute and long-term mental health effects of the COVID-19 pandemic. This study examined the prevalence and predictors of psychological distress before, during, and after a pandemic wave in Switzerland, 2021. Prevalence of psychological distress was estimated in adults aged 35–96 years using the General Health Questionnaire-...

Post-COVID syndrome remains poorly studied in children and adolescents. Here, we aimed to investigate the prevalence and risk factors of pediatric post-COVID in a population-based sample, stratifying by serological status. Children from the SEROCoV-KIDS cohort study (State of Geneva, Switzerland), aged 6 months to 17 years, were tested for anti-SAR...

Physician empathy is considered essential for good clinical care. Empirical evidence shows that it correlates with better patient satisfaction, compliance, and clinical outcomes. These data have nevertheless been criticized because of a lack of consistency and reliability. In this paper, we claim that these issues partly stem from the widespread id...

Objective To investigate staff attitudes toward assisted suicide in the hospital setting in Switzerland. Design Cross-sectional study. Setting Two University Hospitals in French speaking regions of Switzerland. Participants 13’834 health care professionals, including all personnel caring for patients, were invited to participate. Main outcome m...

Background: Implicit prejudice can lead to disparities in treatment. The effects of specialty and experience on implicit obesity and mental illness prejudice had not been explored. The main objective was to examine how specializing in psychiatry/general medicine and years of experience moderated implicit obesity and mental illness prejudice among...

The increasing availability of brain data within and outside the biomedical field, combined with the application of artificial intelligence (AI) to brain data analysis, poses a challenge for ethics and governance. We identify distinctive ethical implications of brain data acquisition and processing, and outline a multi-level governance framework. T...

Background Implicit prejudice can lead to disparities in treatment. The effects of specialty and experience on implicit obesity and mental illness prejudice had not been explored. The main objective was to examine how specializing in psychiatry/general medicine and years of experience moderated implicit obesity and mental illness prejudice among Sw...

Background: Advances in medicine have resulted in treatments that can extend the survival of patients with prolonged disorders of consciousness (PDOC) for several years. However, several diagnostic and prognostic uncertainties remain particularly in the care of pediatric patients. In the absence of international guidelines, we aimed to explore phy...

Background. Existential suffering is often a part of the requests for assisted suicide (AS). Its definitions have gained in clarity recently and refer to a distress arising from an inner realization that life has lost its meaning. There is however a lack of consensus on how to manage existential suffering, especially in a country where AS is legal...

Introduction: Coercion is frequent in clinical practice, particularly in psychiatry. Since it overrides some fundamental rights of patients (notably their liberty of movement and decision-making), adequate use of coercion requires legal and ethical justifications. In this article, we map out the ethical elements used in the literature to justify or...

Understanding the risk of infection from household- and community-exposures and the transmissibility of asymptomatic infections is critical to SARS-CoV-2 control. Limited previous evidence is based primarily on virologic testing, which disproportionately misses mild and asymptomatic infections. Serologic measures are more likely to capture all prev...

Objective: This study aimed to assess the public perception of COVID-19 vaccination certificates as well as potential differences between individuals. Methods: Between 17 March and 1 April 2021, a self-administered online questionnaire was proposed to all persons aged 18 years and older participating in the longitudinal follow-up of SARS-CoV-2 s...

Big data trends in health research challenge the oversight mechanism of the Research Ethics Committees (RECs). The traditional standards of research quality and the mandate of RECs illuminate deficits in facing the computational complexity, methodological novelty, and limited auditability of these approaches. To better understand the challenges fac...

Main results of our research presented at the National Research Program (PNR) 74 Conference, Zürich, 15.11.2021

Background: All over the world, patients die while waiting for a transplant. Facing this difficulty, countries struggle to find efficient procedures and policies. One policy that has recently been enforced in many countries is the presumed consent (opt-out) system for organ donation. In such a system, every individual is considered as a potential...

The implementation of non-user-centered design is sometimes effective for traditionally mass-produced items; however, these methods do not take into account local needs, resources, and cultures, and the history of individual people and communities in low- and middle-income countries (LMIC). This neglect leads to “specialized” solutions based on a n...

Aims: To assess SARS-CoV-2 seroprevalence over the first epidemic wave in the canton of Geneva, Switzerland, as well as risk factors for infection and symptoms associated with IgG seropositivity. Methods: Between April and June 2020, former participants of a representative survey of the 20–74-year-old population of canton Geneva were invited to par...

We envisage the development of new Brain Health Services to achieve primary and secondary dementia prevention. These services will complement existing memory clinics by targeting cognitively unimpaired individuals, where the focus is on risk profiling and personalized risk reduction interventions rather than diagnosing and treating late-stage disea...

Although prevention of dementia and late-life cognitive decline is a major public health priority, there are currently no generally established prevention strategies or operational models for implementing such strategies into practice. This article is a narrative review of available evidence from multidomain dementia prevention trials targeting sev...

Dementia has a devastating impact on the quality of life of patients and families and comes with a huge cost to society. Dementia prevention is considered a public health priority by the World Health Organization. Delaying the onset of dementia by treating associated risk factors will bring huge individual and societal benefit. Empirical evidence s...

The increasing availability of brain data within and outside the biomedical field, combined with the application of artificial intelligence (AI) to brain data analysis, poses a challenge for ethics and governance. We identify distinctive ethical implications of brain data acquisition and processing, and outline a multi-level governance framework. T...

As of June 2021, the European Union (EU) and Switzerland have published information about the introduction of COVID certificates in order to facilitate the safe free movement of their citizens. With implementation underway, little is known about the public perception of such certificates with potential differences in acceptability among individuals...

Background In this article, we address questions regarding how people consider what they do or do not consent to and the reasons why. This article presents the findings of a citizen forum study conducted by the University of Geneva in partnership with the Geneva University Hospitals to explore the opinions and concerns of members of the public rega...

Addressing global health is one of the largest challenges facing humanity in the 21st century, however, this task is becoming even more formidable with the accelerated destruction of the planet. Building on the success of the previous edition, the book outlines how progress towards improving global health relies on understanding its core social, ec...

Background and objectives Coercion in psychiatry is legally tolerated as a last resort. The reduction of the use of coercion is a shared goal of hospital administrators, medical and nursing staff and representatives of patients and families but requires the identification of risk factors for coercion. These risk factors in geriatric psychiatric inp...

Restrictive measures imposed because of the coronavirus disease 2019 (COVID-19) pandemic have resulted in severe social, economic and health effects. Some countries have considered the use of immunity certification as a strategy to relax these measures for people who have recovered from the infection by issuing these individuals a document, commonl...

Background and objectives Coercion in psychiatry is legally tolerated as a last resort. The reduction of the use of coercion is a shared goal of hospital administrators, medical and nursing staff and representatives of patients and families but requires the identification of risk factors for coercion. These risk factors in geriatric psychiatric in...

Background Population-based serological surveys provide a means for assessing the immunologic landscape of a community, without the biases related to health-seeking behaviors and testing practices typically associated with rt-PCR testing. This study assesses SARS-CoV-2 seroprevalence over the first epidemic wave in Canton Geneva, Switzerland, as we...

Rapid medication management for patients infected with HIV, HCV or HBV is key in optimizing a more favourable clinical response, in terms of morbidity, mortality, quality-of-life and reduced risk of transmission. If a drug is expensive, access to treatment for an uninsured patient with limited resources can be a hurdle that leads to forgoing health...

Medical care of adults with disabilities, especially those with intellectual disabilities, can be ethically difficult. Several questions arise frequently. Can we administer a life-saving treatment that could impact negatively the patient's quality of life when the patient isn't able to give consent? During this Covid-19 period, can the use of chemi...

Background: In February 2020, international controversy arose about the ethical acceptability of the WHO Malaria Vaccine Implementation Program (MVIP). Whereas some have argued that this program must be seen as research that is not in line with international ethical standards, notably regarding informed consent and local ethical review, some WHO r...

Background In this article, we raise several questions regarding how people consider what they do or do not consent to and the reasons why. This article presents the findings of a citizen forum study conducted for the University of Geneva in partnership with the Geneva University Hospitals to explore the opinions and concerns of members of the publ...

Objectives To explore prospective participants’ preferences regarding the return of their individual‐specific results from a dementia prevalence study (a probabilistic diagnosis of dementia). Methods/Design We conducted a qualitative study with 22 individuals aged 45‐86 and resident in the Canton of Ticino (Switzerland). Participants had previousl...

The increased use of big data in the medical field has shifted the way in which biomedical research is designed and carried out. The novelty of techniques and methods brought by big data research brings new challenges to institutional review boards (IRBs). Yet it is unclear if IRBs should be the responsible oversight bodies for big data research an...

Background and objectives Coercion is frequent in psychiatry, with an overall downward trend. Knowledge on the application of seclusion and restraint in open wards remains limited. We aimed to describe the prevalence of coercion in an open inpatient setting and identify risk factors for it. Methods We conducted a retrospective analysis of the use...

There is a growing interest in contact tracing apps (CT apps) for pandemic man- agement. These apps raise significant moral concerns. It is therefore crucial to consider ethical requirements before and while implementing such apps. • Public trust is of major importance for population uptake of contact tracing apps. Hasty, ill-prepared or badly comm...

Understanding motivation and resistance factors affecting citizen participation in health and scientific research allows to find solutions to improve citizen engagement and interest in science. Through a survey, we identified the main factors influencing citizens' participation in scientific research, and their wishes to be more informed. Results s...

Background Assessing the burden of COVID-19 on the basis of medically attended case numbers is suboptimal given its reliance on testing strategy, changing case definitions, and disease presentation. Population-based serosurveys measuring anti-severe acute respiratory syndrome coronavirus 2 (anti-SARS-CoV-2) antibodies provide one method for estimat...

Zusammenfassung In diesem Dokument beschreiben wir den Prozess und den Inhalt einer ad hoc Public-Health-Ethikberatung vom 22. März 2020 für eine regionale Gesundheitsbehörde (Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit) zu Entscheidungen im Zusammenhang mit Covid-19.

Major advances in molecular research due to the possibilities offered by high-throughput DNA sequencing, allow for the advancement of “tailor-made” treatments for certain diseases as well as the development of a body of predictive knowledge (such as genetic predisposition, online tests). This “medicine of the future”, driven by bioinformatics and g...

This Policy Brief discusses several prominent ethical challenges of the administration of a COVID-19 vaccine that is expected to be available in the future – yet, will be scarce at first and its distribution will be introduced only stepwise. The Policy Brief reflects on pertinent ethical principles (Population Health Maximization, Justice, Autonomy...

Background: Assessing the burden of COVID-19 based on medically-attended case counts is suboptimal given its reliance on testing strategy, changing case definitions and the wide spectrum of disease presentation. Population-based serosurveys provide one avenue for estimating infection rates and monitoring the progression of the epidemic, overcoming...

This introductory chapter provides a brief history of philosophers’ involvement with the Global Burden of Disease Study, from its origins in the 1990s through the present, showing how the researchers leading the GBD have consistently sought out the advice of philosophers, and how their input has shaped several important aspects of the study. It the...

The Covid-19 pandemic forces policy makers and public health authorities to make ethically challenging decisions, often under conditions of uncertainty and under time pressure. In times of pandemics, ethical accountability is more important, not less. Understanding and handling of ethical problems require grounding in ethical theory and decision mo...

The Krisenstab has asked the NCS-TF to look into the role of serological testing in the COVID-19 response. Several initiatives in Switzerland have sprung up to examine the seroprevalence of SARS-Cov-2 in the population. The Swiss School of Public Health (SSPH+) is planning a nationwide serological testing programme called "Corona Immunitas", using...

READ OPEN ACCESS AT: https://blogs.bmj.com/medical-ethics/2020/04/01/responding-to-the-sars-cov-2-pandemic-experiences-of-an-ad-hoc-public-health-ethics-consultation/

Protecting the vulnerable is recognized as important; but who is vulnerable and what protections are needed? Six definitions of vulnerability are found in the literature: human finitude, an incapacity to defend one’s own interests, fragility, barriers to health, list-based definitions, and layered vulnerability. Because none of these definitions ad...

Countries deciding on deconfinement measures after initial lock-downs in response to the COVID-19 pandemic often include the continued confinement of those most vulnerable to the disease in these plans as a matter of course. Such continued confinement, however, is neither innocuous nor obviously justified. In this paper, we examine more systematica...

The recent increased prevalence of diseases related to unhealthy lifestyles raises difficulties for healthcare insurance systems traditionally based on the principles of risk-management, solidarity, and selective altruism: since these diseases are, to some extent, predictable and avoidable, patients seem to bear some responsibility for their condit...

Background: Although it is the moral duty of physicians to protect vulnerable patients, there are no data on how vulnerability is perceived in clinical practice. This study explores how physicians classify someone as "vulnerable". Method: Thirty-three physicians were initially questioned about resource allocation problems in their work. The resu...

Background: Determining the clinical effects of coercion is a difficult challenge, raising ethical, legal, and methodological questions. Despite limited scientific evidence on effectiveness, coercive measures are frequently used, especially in psychiatry. This systematic review aims to search for effects of seclusion and restraint on psychiatric in...

Background Implicit biases are present in the general population and among professionals in various domains, where they can lead to discrimination. Many interventions are used to reduce implicit bias. However, uncertainties remain as to their effectiveness. Methods We conducted a systematic review by searching ERIC, PUBMED and PSYCHINFO for peer-r...

Background In Switzerland, people can be granted access to assisted suicide (AS) on condition that the person whose wish is to die performs the fatal act, that he has his decisional capacity and that the assisting person’s conduct is not selfishly motivated. No restrictions relating to the ground of suffering are mentioned in the act. Existential s...

Background Training curricula in research ethics for potential and future researchers should be implemented and constantly updated. This requires data regarding training needs. Methods We conducted a cross-sectional survey on residents, fifth and sixth-year medical students registered in the 2006–2007 academic year at the Faculty of Medicine and B...

Big data trends in biomedical and health research enable large-scale and multi-dimensional aggregation and analysis of heterogeneous data sources, which could ultimately result in preventive, diagnostic and therapeutic benefit. The methodological novelty and computational complexity of big data health research raises novel challenges for ethics rev...

Compressed article repository. (ENLX)

Background Medical end-of-life decisions (MELD) and shared decision-making are increasingly important issues for a majority of persons at the end of life. Little is known, however, about the impact of physician characteristics on these practices. We aimed at investigating whether MELDs depend on physician characteristics when controlling for patien...

Conflicts of interest (COIs) do occur in healthcare research, yet their impact on research in the field of infection prevention and control (IPC) is unknown. We conducted a narrative review aiming to identify examples of COIs in IPC research. In addition to well-known instances, we conducted PubMed and Google searches to identify and report case st...

Hepatitis C is a potentially fatal viral infection that mainly affects vulnerable patient groups. Given the high efficacy of the new direct-acting antivirals (DAAs), the World Health Organization (WHO) aims to eliminate viral hepatitis as a global health threat by 2030. However, due to the high cost of DAAs, this recommendation has put significant...

Coercive measures in healthcare are frequently used worldwide, and are especially visible and discussed in psychiatry. Ethical, moral and legal questions have become increasingly frequent over past decades, as medical practice has evolved towards more respectful treatment of patients’ autonomy and rights. In parallel, medicine evolved towards evide...