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Papers by Bernice S Elger

Research paper thumbnail of Animal Research Regulation: Improving Decision-Making and Adopting a Transparent System to Address Concerns around Approval Rate of Experiments

Research paper thumbnail of Ethical Challenges in Oral Healthcare Services Provided by Non-Governmental Organizations for Refugees in Germany

Journal of bioethical inquiry, Feb 14, 2024

Research paper thumbnail of 14 How Should One Die? Nietzsche’s Contribution to the Issue of Suicide in Medical Ethics

Research paper thumbnail of Exploring reasons for recruitment failure in clinical trials: a qualitative study with clinical trial stakeholders in Switzerland, Germany, and Canada

Research paper thumbnail of All Our Data Will Be Health Data One Day: The Need for Universal Data Protection and Comprehensive Consent (Preprint)

Research paper thumbnail of Social Media Terms and Conditions and Informed Consent From Children: Ethical Analysis

JMIR pediatrics and parenting, Apr 22, 2021

Research paper thumbnail of Patient safety issues in office-based surgery and anaesthesia in Switzerland: a qualitative study

Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen, Aug 1, 2017

Research paper thumbnail of Towards a pragmatist dealing with algorithmic bias in medical machine learning

Medicine Health Care and Philosophy, Mar 13, 2021

Research paper thumbnail of Rethinking advanced motherhood: a new ethical narrative

Medicine, Health Care and Philosophy

The aim of the study is to rethink the ethics of advanced motherhood. In the literature, delayed ... more The aim of the study is to rethink the ethics of advanced motherhood. In the literature, delayed childbearing is usually discussed in the context of reproductive justice, and in relationship to ethical issues associated with the use and risk of assisted reproductive technologies. We aim to go beyond these more “traditional” ways in which reproductive ethics is framed by revisiting ethics itself through the lens of the figure of the so-called “older” mother. For this purpose, we start by exploring some of the deep seated socio-cultural discourses in the context of procreation: ageism, ableism and the widespread bias towards geneticism and pronatalism. Afterwards, we provide a critical overview of the key arguments against or in support of advanced motherhood. We then briefly discuss how entrenchment by both sides has produced an impasse in the debate on the ethics of advanced motherhood and proceed by arguing that it is fundamental to bring about a change in this narrative. For this ...

Research paper thumbnail of Consensus recommendations on how to assess the quality of surgical interventions

Research paper thumbnail of Mobile health (mHealth) interventions for psychiatry in Switzerland and Russia: a comparative study

During the past decade, the use of digital technology to promote mental health has increased dram... more During the past decade, the use of digital technology to promote mental health has increased dramatically. Additionally, the consequences of the COVID pandemic, such as travel restrictions and the disruption of face-to-face interactions, have led to an increase in the usage of digital technologies. A wide variety of technologies have been developed, ranging from messaging chat bots to virtual reality technologies and from direct-to-consumer apps to technologies that are fully integrated into clinical care tools. Russia and Switzerland have not been blind spots on the map of such technologies. However, the use of digital technology to promote mental health has taken different paths in these two healthcare settings. The following study is based on the opinions of mental health specialists in both countries in 2019–2020 regarding the use of digital health technologies in psychiatry. We investigate the state of adoption of digital technologies in the field of mental health, the meaning ...

Research paper thumbnail of Bioethical Implications of Vulnerability and Politics for Healthcare in Ethiopia and The Ways Forward

Journal of Bioethical Inquiry

Vulnerability and politics are among the relevant and key topics of discussion in the Ethiopian h... more Vulnerability and politics are among the relevant and key topics of discussion in the Ethiopian healthcare context. Attempts by the formal bioethics structure in Ethiopia to deliberate on ethical issues relating to vulnerability and politics in healthcare have been limited, even though the informal analysis of bioethical issues has been present in traditional Ethiopian communities. This is reflected in religion, social values, and local moral underpinnings. Thus, the aim of this paper is to discuss the bioethical implications of vulnerability and politics for healthcare in Ethiopia and to suggest possible ways forward. First, we will briefly introduce what has been done to develop bioethics as a field in Ethiopia and what gaps remain concerning its implementation in healthcare practice. This will give a context for our second and main task – analyzing the healthcare challenges in relation to vulnerability and politics and discussing their bioethical implications. In doing so, and si...

Research paper thumbnail of Care of Older Persons in Eastern Africa: A Scoping Review of Ethical Issues

Frontiers in Public Health

IntroductionThe aging population is rapidly increasing globally, with 80% of the older population... more IntroductionThe aging population is rapidly increasing globally, with 80% of the older population living in low- and middle-income countries. In Eastern African countries, there exists an incongruence between readiness–economically, structurally, politically, and culturally–to create a conducive environment for healthy aging, which implies public health as well as ethical concerns. The aim of this scoping review was to explore existing evidence addressing the various ethical issues in connection with elder care in the region of Eastern Africa.MethodsWe searched six databases (Africa-Wide Information, AgeLine, CINHAL, MEDLINE, APA PsycInfo, and SocINDEX) to identify peer-reviewed journal articles that could meet some eligibility criteria such as being a peer-reviewed journal article written in English, having been published in any year until July 2020, and focusing on ethical issues in the care of older people aged 60 years and older from Eastern Africa. We also searched for addition...

Research paper thumbnail of Explainability as fig leaf? An exploration of experts’ ethical expectations towards machine learning in psychiatry

AI and Ethics

The increasing implementation of programs supported by machine learning in medical contexts will ... more The increasing implementation of programs supported by machine learning in medical contexts will affect psychiatry. It is crucial to accompany this development with careful ethical considerations informed by empirical research involving experts from the field, to identify existing problems, and to address them with fine-grained ethical reflection. We conducted semi-structured qualitative interviews with 15 experts from Germany and Switzerland with training in medicine and neuroscience on the assistive use of machine learning in psychiatry. We used reflexive thematic analysis to identify key ethical expectations and attitudes towards machine learning systems. Experts’ ethical expectations towards machine learning in psychiatry partially challenge orthodoxies from the field. We relate these challenges to three themes, namely (1) ethical challenges of machine learning research, (2) the role of explainability in research and clinical application, and (3) the relation of patients, physic...

Research paper thumbnail of Kommunikation im medizinischen Alltag : ein Leitfaden für die Praxis

Research paper thumbnail of Forensic-Psychiatric Risk Evaluations: Perspectives of Forensic Psychiatric Experts and Older Incarcerated Persons From Switzerland

Frontiers in Psychiatry, 2021

Background: Forensic-psychiatric risk assessments of persons in prisons aim to provide treatment ... more Background: Forensic-psychiatric risk assessments of persons in prisons aim to provide treatment for their mental health disorders to prevent risk of recidivism. Based on the outcomes of such evaluations, it is decided, for instance, whether the person can be released or be assigned to further treatment with or without privileges. A negative evaluation would mean that the assessed person must remain in prison or in a forensic institution until his or her mental health has improved to live safely in the community. This paper highlights the process of forensic-psychiatric evaluations and the challenges faced by the two parties directly involved in this process in Switzerland.Methods: Data for this manuscript are gathered using semi-structured one-to-one interviews. The study participants included a purposive sample of 41 older incarcerated persons under measures (i.e., mandated by court order to psychotherapeutic and psychiatric treatment), and 23 expert participants working in Swiss ...

Research paper thumbnail of Computing schizophrenia: ethical challenges for machine learning in psychiatry

Psychological Medicine, 2020

Recent advances in machine learning (ML) promise far-reaching improvements across medical care, n... more Recent advances in machine learning (ML) promise far-reaching improvements across medical care, not least within psychiatry. While to date no psychiatric application of ML constitutes standard clinical practice, it seems crucial to get ahead of these developments and address their ethical challenges early on. Following a short general introduction concerning ML in psychiatry, we do so by focusing on schizophrenia as a paradigmatic case. Based on recent research employing ML to further the diagnosis, treatment, and prediction of schizophrenia, we discuss three hypothetical case studies of ML applications with view to their ethical dimensions. Throughout this discussion, we follow the principlist framework by Tom Beauchamp and James Childress to analyse potential problems in detail. In particular, we structure our analysis around their principles of beneficence, non-maleficence, respect for autonomy, and justice. We conclude with a call for cautious optimism concerning the implementat...

Research paper thumbnail of What is your definition of Big Data? Researchers’ understanding of the phenomenon of the decade

Research paper thumbnail of Factors associated with post-acute discharge location after hospital stay: a cross-sectional study from a Swiss hospital

BMC Health Services Research, 2019

Research paper thumbnail of Education and Reproductive Autonomy: The Case of Married Nigerian Women

Narrative inquiry in bioethics, 2017

In this article, we examine the influence of education on the exercise of married women's rep... more In this article, we examine the influence of education on the exercise of married women's reproductive autonomy. We carried out 34 in-depth interviews (IDIs) with purposively sampled married Ikwerre women in Rivers State, Nigeria. The participants were between the ages of 22 and 60, had different educational backgrounds, and were in monogamous and polygynous marriages. Data were analyzed using MAXQDA 11 software. We found that although formal education enhanced women's ability to exercise reproductive autonomy, the culture of demanding absolute respect for men remains a major barrier. Formal education provides women with the knowledge that they need in order to access adequate health services for themselves and their children. Participants also believed that educating men was critical for the exercise of women's reproductive autonomy. The cultural aspects that promote female subordination and patriarchy should be addressed more openly in Nigeria.

Research paper thumbnail of Animal Research Regulation: Improving Decision-Making and Adopting a Transparent System to Address Concerns around Approval Rate of Experiments

Research paper thumbnail of Ethical Challenges in Oral Healthcare Services Provided by Non-Governmental Organizations for Refugees in Germany

Journal of bioethical inquiry, Feb 14, 2024

Research paper thumbnail of 14 How Should One Die? Nietzsche’s Contribution to the Issue of Suicide in Medical Ethics

Research paper thumbnail of Exploring reasons for recruitment failure in clinical trials: a qualitative study with clinical trial stakeholders in Switzerland, Germany, and Canada

Research paper thumbnail of All Our Data Will Be Health Data One Day: The Need for Universal Data Protection and Comprehensive Consent (Preprint)

Research paper thumbnail of Social Media Terms and Conditions and Informed Consent From Children: Ethical Analysis

JMIR pediatrics and parenting, Apr 22, 2021

Research paper thumbnail of Patient safety issues in office-based surgery and anaesthesia in Switzerland: a qualitative study

Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen, Aug 1, 2017

Research paper thumbnail of Towards a pragmatist dealing with algorithmic bias in medical machine learning

Medicine Health Care and Philosophy, Mar 13, 2021

Research paper thumbnail of Rethinking advanced motherhood: a new ethical narrative

Medicine, Health Care and Philosophy

The aim of the study is to rethink the ethics of advanced motherhood. In the literature, delayed ... more The aim of the study is to rethink the ethics of advanced motherhood. In the literature, delayed childbearing is usually discussed in the context of reproductive justice, and in relationship to ethical issues associated with the use and risk of assisted reproductive technologies. We aim to go beyond these more “traditional” ways in which reproductive ethics is framed by revisiting ethics itself through the lens of the figure of the so-called “older” mother. For this purpose, we start by exploring some of the deep seated socio-cultural discourses in the context of procreation: ageism, ableism and the widespread bias towards geneticism and pronatalism. Afterwards, we provide a critical overview of the key arguments against or in support of advanced motherhood. We then briefly discuss how entrenchment by both sides has produced an impasse in the debate on the ethics of advanced motherhood and proceed by arguing that it is fundamental to bring about a change in this narrative. For this ...

Research paper thumbnail of Consensus recommendations on how to assess the quality of surgical interventions

Research paper thumbnail of Mobile health (mHealth) interventions for psychiatry in Switzerland and Russia: a comparative study

During the past decade, the use of digital technology to promote mental health has increased dram... more During the past decade, the use of digital technology to promote mental health has increased dramatically. Additionally, the consequences of the COVID pandemic, such as travel restrictions and the disruption of face-to-face interactions, have led to an increase in the usage of digital technologies. A wide variety of technologies have been developed, ranging from messaging chat bots to virtual reality technologies and from direct-to-consumer apps to technologies that are fully integrated into clinical care tools. Russia and Switzerland have not been blind spots on the map of such technologies. However, the use of digital technology to promote mental health has taken different paths in these two healthcare settings. The following study is based on the opinions of mental health specialists in both countries in 2019–2020 regarding the use of digital health technologies in psychiatry. We investigate the state of adoption of digital technologies in the field of mental health, the meaning ...

Research paper thumbnail of Bioethical Implications of Vulnerability and Politics for Healthcare in Ethiopia and The Ways Forward

Journal of Bioethical Inquiry

Vulnerability and politics are among the relevant and key topics of discussion in the Ethiopian h... more Vulnerability and politics are among the relevant and key topics of discussion in the Ethiopian healthcare context. Attempts by the formal bioethics structure in Ethiopia to deliberate on ethical issues relating to vulnerability and politics in healthcare have been limited, even though the informal analysis of bioethical issues has been present in traditional Ethiopian communities. This is reflected in religion, social values, and local moral underpinnings. Thus, the aim of this paper is to discuss the bioethical implications of vulnerability and politics for healthcare in Ethiopia and to suggest possible ways forward. First, we will briefly introduce what has been done to develop bioethics as a field in Ethiopia and what gaps remain concerning its implementation in healthcare practice. This will give a context for our second and main task – analyzing the healthcare challenges in relation to vulnerability and politics and discussing their bioethical implications. In doing so, and si...

Research paper thumbnail of Care of Older Persons in Eastern Africa: A Scoping Review of Ethical Issues

Frontiers in Public Health

IntroductionThe aging population is rapidly increasing globally, with 80% of the older population... more IntroductionThe aging population is rapidly increasing globally, with 80% of the older population living in low- and middle-income countries. In Eastern African countries, there exists an incongruence between readiness–economically, structurally, politically, and culturally–to create a conducive environment for healthy aging, which implies public health as well as ethical concerns. The aim of this scoping review was to explore existing evidence addressing the various ethical issues in connection with elder care in the region of Eastern Africa.MethodsWe searched six databases (Africa-Wide Information, AgeLine, CINHAL, MEDLINE, APA PsycInfo, and SocINDEX) to identify peer-reviewed journal articles that could meet some eligibility criteria such as being a peer-reviewed journal article written in English, having been published in any year until July 2020, and focusing on ethical issues in the care of older people aged 60 years and older from Eastern Africa. We also searched for addition...

Research paper thumbnail of Explainability as fig leaf? An exploration of experts’ ethical expectations towards machine learning in psychiatry

AI and Ethics

The increasing implementation of programs supported by machine learning in medical contexts will ... more The increasing implementation of programs supported by machine learning in medical contexts will affect psychiatry. It is crucial to accompany this development with careful ethical considerations informed by empirical research involving experts from the field, to identify existing problems, and to address them with fine-grained ethical reflection. We conducted semi-structured qualitative interviews with 15 experts from Germany and Switzerland with training in medicine and neuroscience on the assistive use of machine learning in psychiatry. We used reflexive thematic analysis to identify key ethical expectations and attitudes towards machine learning systems. Experts’ ethical expectations towards machine learning in psychiatry partially challenge orthodoxies from the field. We relate these challenges to three themes, namely (1) ethical challenges of machine learning research, (2) the role of explainability in research and clinical application, and (3) the relation of patients, physic...

Research paper thumbnail of Kommunikation im medizinischen Alltag : ein Leitfaden für die Praxis

Research paper thumbnail of Forensic-Psychiatric Risk Evaluations: Perspectives of Forensic Psychiatric Experts and Older Incarcerated Persons From Switzerland

Frontiers in Psychiatry, 2021

Background: Forensic-psychiatric risk assessments of persons in prisons aim to provide treatment ... more Background: Forensic-psychiatric risk assessments of persons in prisons aim to provide treatment for their mental health disorders to prevent risk of recidivism. Based on the outcomes of such evaluations, it is decided, for instance, whether the person can be released or be assigned to further treatment with or without privileges. A negative evaluation would mean that the assessed person must remain in prison or in a forensic institution until his or her mental health has improved to live safely in the community. This paper highlights the process of forensic-psychiatric evaluations and the challenges faced by the two parties directly involved in this process in Switzerland.Methods: Data for this manuscript are gathered using semi-structured one-to-one interviews. The study participants included a purposive sample of 41 older incarcerated persons under measures (i.e., mandated by court order to psychotherapeutic and psychiatric treatment), and 23 expert participants working in Swiss ...

Research paper thumbnail of Computing schizophrenia: ethical challenges for machine learning in psychiatry

Psychological Medicine, 2020

Recent advances in machine learning (ML) promise far-reaching improvements across medical care, n... more Recent advances in machine learning (ML) promise far-reaching improvements across medical care, not least within psychiatry. While to date no psychiatric application of ML constitutes standard clinical practice, it seems crucial to get ahead of these developments and address their ethical challenges early on. Following a short general introduction concerning ML in psychiatry, we do so by focusing on schizophrenia as a paradigmatic case. Based on recent research employing ML to further the diagnosis, treatment, and prediction of schizophrenia, we discuss three hypothetical case studies of ML applications with view to their ethical dimensions. Throughout this discussion, we follow the principlist framework by Tom Beauchamp and James Childress to analyse potential problems in detail. In particular, we structure our analysis around their principles of beneficence, non-maleficence, respect for autonomy, and justice. We conclude with a call for cautious optimism concerning the implementat...

Research paper thumbnail of What is your definition of Big Data? Researchers’ understanding of the phenomenon of the decade

Research paper thumbnail of Factors associated with post-acute discharge location after hospital stay: a cross-sectional study from a Swiss hospital

BMC Health Services Research, 2019

Research paper thumbnail of Education and Reproductive Autonomy: The Case of Married Nigerian Women

Narrative inquiry in bioethics, 2017

In this article, we examine the influence of education on the exercise of married women's rep... more In this article, we examine the influence of education on the exercise of married women's reproductive autonomy. We carried out 34 in-depth interviews (IDIs) with purposively sampled married Ikwerre women in Rivers State, Nigeria. The participants were between the ages of 22 and 60, had different educational backgrounds, and were in monogamous and polygynous marriages. Data were analyzed using MAXQDA 11 software. We found that although formal education enhanced women's ability to exercise reproductive autonomy, the culture of demanding absolute respect for men remains a major barrier. Formal education provides women with the knowledge that they need in order to access adequate health services for themselves and their children. Participants also believed that educating men was critical for the exercise of women's reproductive autonomy. The cultural aspects that promote female subordination and patriarchy should be addressed more openly in Nigeria.