Publications - Centre for Medical Ethics

• Nordenfelt, Lennart & Hofmann, Bjørn Morten (2027). Dignity. In Nesi, Hilary & Milin, Petar (Ed.), Reference Module in Social Sciences. Elsevier. ISSN 9780443157851. p. 1–7. doi: 10.1016/b978-0-443-15715-8.00018-2. Full text in Research Archive
• Hermansen, Karin Berg; Sævareid, Trygve Johannes Lereim; Pedersen, Reidar; Alnes, Rigmor Grete Einang; Brøderud, Linn & Romøren, Maria [Show all 7 contributors for this article] (2026). Healthcare professionals’ experiences of advance care planning conversations with frail older adults admitted to acute geriatric hospital units: a nested qualitative study. BMC Health Services Research. 26. doi: 10.1186/s12913-026-15112-x. Full text in Research Archive Show summary

  Background: Advance care planning can support frail older adults, their next of kin, and healthcare professionals by clarifying patients’ values and preferences and improving communication toward the end of life. Despite these benefits, advance care planning remains underutilized, particularly among frail older adults with complex needs. Limited research has explored healthcare professionals’ experiences with initiating it in acute geriatric settings. As part of a broader research project focused on implementing advance care planning for older adults admitted to acute geriatric hospital units, this study aimed to explore healthcare professionals’ experiences with initiating these conversations. Methods: A qualitative sub-study, nested within a cluster randomized controlled trial, was conducted with implementation teams and other healthcare professionals from the six geriatric units in the intervention arm. They had recently started engaging in advance care planning with frail, acutely ill older patients and their next of kin. Data were collected through four focus groups and four dyadic interviews, involving a total of 24 participants. The data was analysed by using reflexive thematic analysis. Results: Four themes developed as perceived benefits: (1) Amplifies the patients’ voice, (2) Improves communication with next of kin, (3) Influences treatment decisions and may avoid overtreatment (4) Contributes to meaningful work. Two themes developed as perceived challenges: (1) Uncertainty regarding the ACP documentation, (2) ACP conversations require dedicated time and focus. Conclusion: This study revealed that advance care planning conversations in acute geriatric hospital units can amplify patients’ voices and promote their participation in decision-making. Discussions about existential topics appear beneficial and rewarding for patients, next of kin and healthcare professionals, both for in-moment and future decisions. Time constraints may have led to missed opportunities to initiate ACP conversations with patients before the end of life, while documentation issues may have limited their impact on continuity of care. Trial registration https://ClinicalTrials.gov Identifier NCT05681585. Registered 03.01.23.

• Hofmann, Bjørn Morten (2026). On the tetrad of human malady: disease, illness, sickness, and existential suffering. Medicine, Health care and Philosophy. ISSN 1386-7423. p. 1–12. doi: 10.1007/s11019-026-10397-5. Full text in Research Archive Show summary

  The triad of disease, illness, and sickness is well established in the philosophy, sociology, and anthropology of medicine as well as in clinical practice. Nonetheless, the triad is criticized for being too simplistic and for excluding important aspects of human suffering. One such critique is that it does not account for existential suffering, which is especially relevant in severe and life-threatening diseases. Accordingly, this study investigates whether existential suffering adds to the concepts of disease, illness, and sickness making up a tetrad of human malady. To do so, I investigate the concept of existential suffering, which is frequently described in medical terms, is diagnosed, acknowledged by health professionals, managed in treatments and care, and recognized in disease classification systems. Then I present ontological, epistemological, conceptual, normative, and pragmatic justifications for extending the triad of disease, illness, and sickness with existential suffering. Lastly, I will discuss counterarguments and objections to the various justifications. I conclude that on specific premises existential suffering can be a relevant extension of the triad to a tetrad of human malady, especially in cases of severe and life-threatening disease, but that we need to avoid medicalizing existential suffering and making health professionals masters over human meaning-making.

• Hofmann, Bjørn Morten (2026). Improving bioethics by clarifying and elaborating its methodology: a response to Gomez-Virseda and colleagues. Medicine, Health care and Philosophy. ISSN 1386-7423. doi: 10.1007/s11019-026-10368-w. Full text in Research Archive Show summary

  In a recent article Gomez-Virseda and coauthors criticize my previous work on methodology in bioethics and argue that bioethics is a discipline. While I think that Gomez-Virseda and co-authors misconstrue my argument, state the obvious, and fail to address pressing questions to their argument, I am most thankful for the inspiration and opportunity to elaborate on why methodology matters for consolidating bioethics’ professional standing, to improving its quality, ascertaining its academic and educational importance, and to advancing its trustworthiness and social impact.

• Hofmann, Bjørn Morten (2026). On the Concept of Existential Disease. Health Care Analysis. ISSN 1065-3058. doi: 10.1007/s10728-026-00595-w. Full text in Research Archive Show summary

  Is “existential disease” a meaningful concept? This study scrutinizes six arguments in support of the concept. First, putative existential diseases are already discussed in the academic literature, including existential neurosis and existential OCD. Second, existential disease may be understood as occurring in the absence of “existential health,” a notion that has received increasing scholarly attention. Third, the very practices of diagnosing “existential suffering” and providing “existential therapy” appear to entail a concept of existential disease. Fourth, in the same way as physical and mental suffering corresponds to physical and mental disease, existential suffering corresponds to existential disease. Fifth, existential suffering arguably falls under several traditional definitions of disease, thereby supporting the legitimacy of the concept of existential disease. Sixth, medical interventions such as palliative sedation and assisted dying in response to existential suffering—interventions typically reserved for disease—seem to presuppose an existential form of disease. Although most of these arguments face important objections, certain conceptions of disease do warrant the category of existential disease. Nonetheless, there is a substantial risk of medicalizing existential concerns, and it is not clear that framing existential suffering as disease is the best way to respond to those who suffer existentially, especially given that health professionals may not be well equipped to address such forms of distress. Hence, more and better arguments are needed to ascertain the concept of existential disease.

• Vahedi, Ali; Eriksdotter, Maria; Ihle-Hansen, Hege Beate; Wyller, Torgeir Bruun; Øksengård, Anne Rita & Fure, Brynjar (2026). Impact of Acute Functional Decline on Frailty and Mortality in Acutely Hospitalized Older Persons. Aging Medicine. ISSN 2475-0360. p. 1–10. doi: 10.1002/agm2.70104. Full text in Research Archive
• Porthun, Jan; Andenæs, Stine; Brandsæter, Ingrid Øfsti; Hofmann, Bjørn Morten & Kjelle, Elin (2026). CT sinus imaging utilization in Norway: trends over time and variation by region, age, and sex. Research in Health Services and Regions. 5. doi: 10.1007/s43999-026-00094-4. Full text in Research Archive Show summary

  Abstract Background Computed tomography (CT) of the sinuses is a standard component of radiological diagnostics. CT of the sinuses are often regarded as low-value care owing to their minimal impact on disease management. The aim of this study is to describe geographical and temporal variations in outpatient CT sinus utilisation in Norway from 2013 to 2023. Methods Administrative data on outpatient CT sinus performed in Norway between 2013 and 2023 were analysed. Descriptive statistics were performed on both unadjusted and adjusted data. Measures of geographical variation applied were: the coefficient of variation (CV), the extremal quotient (EQ), and the systematic component of variation (SCV). Sex-specific differences were formally examined by comparing female and male rates using Mantel–Haenszel standardised statistical measures. Results Between 2013 and 2023, the sex- and age-adjusted rates of CT sinus per 10,000 individuals in Norway decreased from 52 to 46. The EQ increased from 2.42 to 3.86, the CV from 26% to 31% and SCV values from 6.10 to 8.76, indicating a high level of geographical variation. The ratio of female to male for CT sinus is 1.42 (SD ± 0.11). Conclusions The decline in CT sinus is partially linked to the coronavirus pandemic and is likely attributable to the ‘Choosing Wisely’ campaign. Geographical variability, evident from 2013 to 2015 and becoming more pronounced through 2023, indicates differing CT sinus routines across hospital catchment areas in Norway. It is possible that a substantial proportion of examinations conducted on women may constitute low-value care.

• Hoff, Eivor Hovde; Hofmann, Bjørn Morten; Kraft, Kristian Bandlien; Mykletun, Arnstein & Østby, Kristian Amundsen (2026). Variations in general practitioners’ referrals to low-value MRI examinations in Norway: A nationwide register-based study. European Journal of General Practice. ISSN 1381-4788. 32(1). doi: 10.1080/13814788.2026.2706207. Full text in Research Archive Show summary

  Background Large variations in diagnostic imaging use raise concerns about low-value care, inequity, and inefficient use of resources. Magnetic resonance imaging (MRI) of the head, lumbosacral spine, and knee has been identified as potentially low-value examinations in several clinical contexts. Objectives To examine variation in general practitioners’ referrals to low-value MRI examinations in Norway and assess whether differences are associated with GP and practice characteristics. Methods Using national registry data, we linked patients’ completed MRI examinations to their regular GP and calculated GP-specific MRI rates per 1000 listed patients. We classified GPs into deciles and compared the characteristics of GPs in the highest (High-10) and lowest (Low-10) referral deciles. We examined predictors of variation using pooled OLS regression models with year fixed effects and GP-clustered standard errors. Results GPs in the top referring decile (High-10) referred patients for potentially low-value MRI examinations at three times the rate of those in the lowest referring decile (Low-10). Experienced (specialist-certified) GPs referred approximately 2.7 fewer examinations per 1000 listed patients per year than less experienced GPs (non-specialists). Shorter consultation times, higher consultation frequency and higher hourly fee income were all associated with higher MRI use – with the strongest association for private MRI. A higher patient disease burden was associated with more total examination, but fewer private examinations per 1000 listed patients per year. Conclusion Referral rates varied markedly between GPs. Specialist-certified GPs had lower rates than non-specialists, and higher activity levels and income from fees were associated with higher referral rates – particularly to private providers.

• Ddamulira, Christopher; Opolot, Hellen; Mutumba, Beth; Lamunu, Dorcas; Ssebale, Steven & Semakula, Irene [Show all 11 contributors for this article] (2026). A Qualitative Exploration of Stakeholder Experiences and Perceptions of Uganda’s Clinical Research Policies and Guidelines During the COVID-19 Pandemic. Open Research Europe. 6, p. 297–297. doi: 10.12688/openreseurope.24264.1. Full text in Research Archive Show summary

  Background The COVID-19 pandemic disrupted research globally, placing unprecedented pressure on regulatory systems. In Uganda, research ethics committees (RECs) and regulatory bodies faced challenges in maintaining oversight, ethical compliance, and continuity of research. Specifically, the study explored stakeholder experiences and perceptions of how Uganda’s clinical research policies and guidelines were implemented and how they influenced the conduct of ethical and safe research during the COVID-19 pandemic. Methods A qualitative descriptive study was conducted across seven districts, involving all UNCST-accredited RECs. Data were collected through in-depth interviews, focus group discussions, and key informant interviews with 56 participants, including REC Chairpersons, administrators, researchers, and representatives from research regulatory authorities in Uganda. Purposive sampling ensured recruitment of participants with relevant expertise. Virtual interviews were audio-recorded, transcribed verbatim, and analyzed using thematic analysis. Ethical approval and informed consent were obtained. Results Uganda’s research policies and guidelines were reported by participants to support continuity of research through strengthened collaboration, including joint protocol reviews and coordinated regulatory processes. Standardization and adaptive measures, such as digital submissions, virtual meetings, remote monitoring, and hybrid consent models, were perceived to enhance efficiency and facilitate study adjustments. However, constraints including increased workload, limited oversight due to movement restrictions, and financial challenges persisted, highlighting the need for more adaptable and resilient regulatory systems. Conclusions Uganda’s research policies and guidelines were perceived to supported continuity of ethical research during the pandemic through strengthened collaboration and standardized yet adaptable regulatory processes. However, operational and resource constraints highlighted gaps in system resilience. Strengthening digital infrastructure, institutionalizing collaborative review mechanisms, embedding adaptable procedures, and securing emergency research funding will be critical to enhance the responsiveness and resilience of Uganda’s research regulatory system in future public health emergencies.

• Voinov, Cristiana-Anca; Hagen, Lene A.; Baraas, Rigmor C.; Bernabe, Rosemarie DLC & Dawkins, Shereen Cox Née (2026). Mapping risks and harms of eXtended reality (XR) technologies – A scoping review and novel typology. Open Research Europe. 6, p. 203–203. doi: 10.12688/openreseurope.23621.1. Full text in Research Archive Show summary

  This article uses a scoping review method to extensively map risks and harms related to the design, development and application of XR technologies (VR, MR, AR, virtual environments, and metaverses). Through the application of qualitative content analysis, thematic categories emerged which were developed into a novel typology of risks comprising of six main themes and 19 sub-themes: 1) health and wellbeing (cognitive, psycho-emotional, socio-relational and physical), 2) autonomy (privacy, self-sovereignty, surveillance, authenticity), 3) epistemic and scientific (epistemic uncertainty, scientific uncertainty, algorithmic imperfection, manipulation), 4) normative (norm violations, rights violations), 5) structural (socio-political, economic/financial, legal), and 6) technical safety and security (security, dual use). Further considerations identified were risks pertaining to special populations (vulnerable groups), unknown risks and long-term use effects. A subsidiary aim was to map risk mitigations. Other key findings, such as geographical distribution of sources, and use cases, among others, are featured, lending to a robust discussion on the state of XR risks, potential motivators for development of XR harm mitigation-strategies, and key knowledge gaps.

• Hermansen, Karin Berg; Sævareid, Trygve Johannes Lereim; Pedersen, Reidar; Alnes, Rigmor Grete Einang; Brøderud, Linn & Romøren, Maria [Show all 7 contributors for this article] (2026). Ethical challenges in acute geriatric care and advance care planning: a nested qualitative study. European Geriatric Medicine. ISSN 1878-7649. p. 1–11. doi: 10.1007/s41999-026-01563-2. Full text in Research Archive Show summary

  Purpose Ethical challenges are common in geriatrics, and moral dilemmas and conflicting interests can arise in advance care planning (ACP). Respecting the wishes of frail, acutely ill older patients while acting in their best interests can be challenging. This study was nested within a cluster randomized controlled trial aimed at implementing ACP in acute geriatric hospital units. The aim of this study was to explore clinicians’ experiences of ethical challenges in geriatric units before and during this implementation project. Methods Eight semi-structured interviews—four focus groups and four dyadic interviews—were conducted with a total of twenty-four participants, including implementation teams and other clinicians from the six intervention units. These participants had engaged in ACP with frail, acutely ill older patients and, preferably, their next of kin. The data were analyzed using Braun and Clarke’s reflexive thematic analysis. Results Four themes were developed: (1) navigating prognostic uncertainty while sustaining hope, (2) providing information that enables understanding and participation, (3) managing family disagreements and emotional strain, and (4) preserving dignity towards the end of life. The findings indicate that ethical challenges were often mitigated rather than intensified through ACP conversations. Conclusion Ethical challenges in acute geriatric care arose when patient autonomy was limited by cognitive impairment, unclear preferences, or family disagreement. Earlier preparation of patients and next of kin through ACP could facilitate early identification of potential disagreements and provide a stronger foundation for dialogue in acute situations.

• Hol, Bjørn Ottar; Barra, Mathias & Solberg, Carl Tollef (2026). Public Opinion on Organ Conscription and Free Riding: Results from a Norwegian Survey. Etikk i praksis. ISSN 1890-3991. 20(1), p. 9–22. doi: 10.5324/eip.v20i1.6603. Full text in Research Archive Show summary

  Shortage of organs for transplantation leads to reduced quality of life and premature deaths among patients on waiting lists. One proposed policy response is the conscription of cadaveric organs, whereby all suitable organs are retrieved after death. Another proposal is to restrict access to transplantation for patients who have not themselves consented to donate. The ethical acceptability of both policies remains contested, and empirical evidence on public opinion is limited. Previous surveys suggest low support for conscription. We conducted a national survey of adults in Norway (N = 1000) to investigate public attitudes towards the badness of death (reported elsewhere), the conscription of organs for transplantation, and reciprocity, understood as the acceptance to be a potential donor as necessary for being a potential recipient of organs if in need. This last question did not elicit conclusive responses. It did, however, show a correlation between responses supportive of reciprocity (i.e., against free riding) and those supportive of conscription. The results suggest a slight majority in favor of conscription in Norway. Our survey shows that belief in an afterlife corresponds negatively with acceptance of conscription, but no other demographic data are influential.

• Adams, Jonathan (2026). “Hermeneutic burden” and clinical responsibility: a response to Sparrow et al. on explanation and machine learning. Monash Bioethics Review. ISSN 1321-2753. doi: 10.1007/s40592-026-00300-6. Full text in Research Archive Show summary

  This paper critically reviews Sparrow et al.’s notion of the “hermeneutic burden” placed upon clinicians by the demand for explainable artificial intelligence (XAI) in the context of adaptive machine learning (ML) systems. While Sparrow et al. highlight important additional labour that may be required of clinicians, this response argues that framing explanation primarily in terms of such a burden obscures its overall ethical significance. This paper therefore offers a supplementary account of the interpretive work associated with XAI in medicine that places it within existing models of the patient–clinician relationship. In particular, Emanuel and Emanuel’s influential typology consisting of four models of the patient–physician relationship is used to extract possible justifications for the responsibility to grasp and explain not only patients’ values and conditions but also ML outputs. This allows us to distinguish between ‘hermeneutic burden’ and ‘hermeneutic responsibility’ and emphasise that explanation in medicine is not an incidental task but part of a clinician’s professional role, particularly on ‘interpretive’ and ‘deliberative’ models. The paper thus argues that viewing explanation as a hermeneutic responsibility linked to patient autonomy clarifies the ethical significance of XAI in terms of both the grounds and scope of clinicians’ responsibilities. At its core, the ethical challenge raised by XAI in clinical practice concerns not only the burdens it may impose on clinicians but also the evolution of clinicians’ traditional interpretive duties in the novel context of ML-mediated care.

• argibay, Miguel Garcia; Hofstad, Tore; Bjelland, Ingvar; Cortese, Samuele & Mykletun, Arnstein (2026). ADHD medication discontinuation and non-adherence: a Norwegian population-based register study. BMJ Mental Health. 29(1). doi: 10.1136/bmjment-2026-302649. Full text in Research Archive Show summary

  Background Poor persistence and adherence to attention-deficit/hyperactivity disorder (ADHD) medication is a significant barrier to effective long-term care, particularly during adolescence, yet age-specific and sex-specific trajectories remain poorly characterised. Objective To characterise medication initiation, discontinuation and long-term adherence patterns for children and adolescents diagnosed with ADHD in a real-world setting. Methods A nationwide retrospective cohort study, including 8961 children and adolescents (aged <18 years) with a new ADHD diagnosis in child and adolescent mental health services between 1 January 2010 and 31 December 2012, with follow-up until 31 December 2021. Main outcomes were medication initiation rates; time to first medication discontinuation, analysed using Kaplan-Meier estimates and restricted mean survival time at 1 year and longitudinal adherence, measured by the proportion of days covered over 9 years. Findings Of the 8961 individuals in the cohort (mean age at diagnosis, 12 years; 69% male), 6661 (74.3%) initiated medication, with a median time from diagnosis to initiation of 106 days (IQR 17–231); 55% initiated within 90 days. Discontinuation increased significantly with age; adolescents aged 15–17 years remained on treatment for 31.9 fewer days (95% CI −40.8 to −23.1; p<0.001) in the first year compared with children aged 5–11 years. Females also discontinued significantly earlier than males (difference −13.2 days; 95% CI −19.8 to −6.5; p<0.001). Longitudinal analysis confirmed that older age at initiation and female sex were associated with a significantly steeper decline in medication coverage over time. Conclusions Discontinuation and low adherence to ADHD medication were common and increased substantially through adolescence, with females at higher risk of early cessation. Clinical implications Late adolescence warrants closer clinical monitoring and shared decision-making to support appropriate treatment continuation or well-informed discontinuation, particularly for older adolescents and females. Integrating structured transition planning and attention to sex-specific barriers may help reduce avoidable non-adherence during this high-risk period.

• Meena, Devotha Adolph; Wangamati, Cynthia Khamala; Lyakurwa, Michael Felician & Kuhumba, Shija Kevin (2026). Navigating Abortion in a Restrictive Legal Context: A Qualitative Study of Students’ Experiences in a Tanzanian University. Women's Reproductive Health. ISSN 2329-3691. doi: 10.1080/23293691.2026.2674856. Full text in Research Archive
• Lium, Marius Aleksander; Rugkåsa, Jorun; Hofstad, Tore; Lurås, Hilde & Nyttingnes, Olav (2026). Temporal patterns in compulsory psychiatric admissions: a four-year, nationwide registry study from Norwegian acute wards. Nordic Journal of Psychiatry. ISSN 0803-9488. 80(4), p. 257–264. doi: 10.1080/08039488.2026.2670376. Full text in Research Archive
• Feiring, Ingvild Hjorth; Pedersen, Reidar; Kirkevold, Øyvind; Surr, Claire; Sabbata, Kevin De & Steyaert, Jan [Show all 13 contributors for this article] (2026). Is capacity to consent to healthcare a uniformly defined concept? Insights from a document analysis of laws and national guidelines across six European countries. International Journal of Law and Psychiatry. ISSN 0160-2527. 108. doi: 10.1016/j.ijlp.2026.102235. Full text in Research Archive
• Bentzen, Heidi Beate; Gaillard, Maxence; Nachman, Iftach; Reumann, Daniel; Gadegaard, Nikolaj & David, Laurent [Show all 14 contributors for this article] (2026). A guide to using embedded ethics in human stem-cell-based embryo model research. Nature Cell Biology. ISSN 1465-7392. 28(4), p. 665–673. doi: 10.1038/s41556-026-01909-9. Full text in Research Archive
• Norheim, Irene; Røssberg, Jan Ivar; Selle, Maria Lie; Woodberry, Kristen; O'Brien, Mary & Pedersen, Reidar [Show all 11 contributors for this article] (2026). Expressed emotions and caregiving appraisals among relatives of patients with psychotic disorders: a cross-sectional study. BMC Psychiatry. 26(1). doi: 10.1186/s12888-026-07868-7. Full text in Research Archive
• Ruud, Torleif; Drake, Robert E.; Selle, Maria Lie; Hartveit, Miriam; Drivenes, Karin & Heiervang, Kristin Sverdvik [Show all 16 contributors for this article] (2026). Sustainment of Four Evidence-Based Treatments for Patients with Psychosis: A Prospective Cohort Study in Norway. Administration and Policy in Mental Health and Mental Health Services Research. ISSN 0894-587X. doi: 10.1007/s10488-026-01493-y. Full text in Research Archive Show summary

  Research on sustainment of implemented evidence-based practices (EBPs) for people with psychosis has been limited in mental health services. This prospective cohort study extended a cluster-randomized trial (trial registration number NCT03271242) of implementation of four EBPs in Norwegian mental health services. In the trial 39 clinical units were randomized to receive implementation support for one of two chosen EBPs. This study aimed to measure sustainment for two biological EBPs (physical health care, antipsychotic medication management) and two psychosocial EBPs (family psychoeducation, illness management and recovery), and to explore factors influencing sustainment. Fidelity to the EBP with implementation support was measured after 18 months of implementation support and at 36 months (18 months post-implementation), additionally key informants reported factors influencing sustainment. Among 27 sites with high or moderate fidelity at 18 months, 20 (74%) sustained the practice at the same or higher level at 36 months; 10 of 13 sites, most with psychosocial EBPs, sustained high fidelity, and 10 of 14 sites, most with biological EBPs, sustained moderate fidelity. Sustaining sites demonstrated significantly greater efforts to continue the EBP, while non-sustaining sites encountered greater barriers including leadership change or key clinician turnover. With efforts to continue the EBP, most sites sustained the practice with high fidelity for psychosocial EBPs and moderate fidelity for biological practices. A clinical director or champion determined to continue the practice together with a trained clinical staff were the two main ingredients for sustainment.

• Hofmann, Bjørn Morten (2026). Responsive Equanimity to Uncertainty: Towards the Construction of a Concept for Handling Medical Uncertainty in Clinical Practice. Health Care Analysis. ISSN 1065-3058. doi: 10.1007/s10728-026-00562-5. Full text in Research Archive Show summary

  The objective of this study is to elaborate an overall concept of addressing uncertainty in clinical practice that covers a series of specific characteristics. To do so, a conceptual engineering approach has been applied, starting with describing the concepts that exist and are in use. Based on this description the functional quality of these concepts (representational devices) is evaluated and a series of criteria for an improved concept is developed. Four alternatives, each with special merits, are presented, suitable for different context, i.e., bearing the burdens of uncertainty, mindful adaptability, compassionate resilience, and responsive equanimity. Among these, responsive equanimity emerges as the most robust generic concept, meeting the majority of criteria at a general level. These results are open for debate and revision before implementation and evaluation.

• Fystro, Joar Røkke (2026). Skal offentlige sykehus kunne selge fosterdiagnostikk? En kvalitativ analyse av høringsdokumenter. Nordisk tidsskrift for helseforskning. ISSN 1504-3614. 22(1). doi: 10.7557/14.8173. Full text in Research Archive Show summary

  I november 2023 sendte regjeringen Støre et forslag på høring om at gravide uten indikasjon for fosterdiagnostikk likevel skulle kunne få utføre non-invasiv prenatal test (NIPT) på offentlige sykehus så lenge de selv betaler markedsprisen for testen. Hensikten med denne studien var å undersøke argumentene og begrunnelsene som ble brukt i høringsrunden. Den kvalitative analysen viser hvordan myndighetene la vekt på praktisk-empiriske argumenter om at forslaget ville gi likere tilgang til NIPT rundt om i landet og bidra til å holde helsepersonell i offentlig tjeneste, mens høringsinstansene pekte på de prinsipielle konsekvensene av forslaget. Hvorvidt regjeringen ikke hadde tatt høyde for de potensielle følgeeffektene av å tillate privat markedslogikk innenfor de offentlige sykehusdørene, eller om den la frem forslaget som en testballong for å innføre lignende løsninger, forblir uklart. En annen mulighet er at den mente NIPT skiller seg fra andre helsetjenester og at forslaget dermed ikke ville skape presedens for lignende betalingsløsninger.

• Kjelle, Elin; Brandsæter, Ingrid Øfsti; Porthun, Jan & Hofmann, Bjørn Morten (2026). Referral quality and justification rate in MRI for the lower back: evaluation of an intervention to reduce imaging of low value. Acta Radiologica. ISSN 0284-1851. doi: 10.1177/02841851261424495. Full text in Research Archive Show summary

  Background Lower back magnetic resonance imaging (MRI) is a common imaging procedure; however, it often has low value in patients with uncomplicated back pain. Measures to reduce low-value procedures are necessary for a sustainable imaging service. Purpose To evaluate the outcomes of the national intervention implemented in imaging centers by assessing referral quality and justification rate of lower back MRI in private imaging centers in Norway. Material and Methods This study used a before-after design to assess referrals retrospectively for justification and information quality to evaluate the intervention's effect. Four radiologists and four radiographers, all experienced in the field, assessed 360 referrals, half from before and half after the intervention. Descriptive, comparative, and Kappa statistics were used to analyze the data. Results The rate of justified referrals increased from 60% to 65% when comparing before and after the implementation. The rate of unjustified referrals was reduced from 24% before to 19% after. The rate of referrals that lacked information was unchanged. Further, referral quality slightly increased after the intervention; still, 88% of the referrals were considered low quality. Radiologists were stricter in their assessment of referrals compared to radiographers. The interrater agreement was moderate in justification assessment and very good in referral quality assessment. Conclusion The intervention slightly improved referral quality and justification rate. However, with a 20% unjustified rate after the intervention, further measures are needed to increase service quality and reduce wait times.

• Adams, Jonathan (2026). Aesthetic injustice in healthcare: exploring testimonial and hermeneutical forms. Medicine, Health care and Philosophy. ISSN 1386-7423. doi: 10.1007/s11019-026-10334-6. Full text in Research Archive Show summary

  This paper introduces and develops the concepts of aesthetic testimonial injustice and aesthetic hermeneutical injustice, arguing that understanding the aesthetic dimensions of human experience, specifically those concerning physical appearance, is central to justice in healthcare practice. Drawing on Miranda Fricker’s framework of epistemic injustice, the paper provides a bridge between emerging literature on aesthetic injustice, which is often focused on lookism and appearance-based discrimination, and accounts that emphasize the recognition of individuals as aesthetic subjects. The concept of aesthetic testimonial injustice relates to the unjust discrediting of a person’s aesthetic testimony regarding their own body, often due to biases related to attractiveness, age or disability. Aesthetic hermeneutical injustice, by contrast, pertains to the structural disadvantage faced by individuals who lack the interpretive resources to make sense of or communicate their aesthetic experience as it pertains to bodily appearance, particularly in healthcare contexts. Using examples from prosthetics design, nursing care and disorders of visual perception, the paper shows how healthcare systems can marginalize patients’ aesthetic values and perceptions, thereby undermining their dignity and agency. It concludes by calling for a deeper understanding of aesthetics in bioethics, suggesting that respecting patients as embodied aesthetic agents can enhance ethical healthcare delivery and counter systemic injustice. The concepts of aesthetic testimonial injustice and aesthetic hermeneutical injustice thus expand bioethical discourse by highlighting the moral significance of aesthetic experience in healthcare contexts.

• Simpson, Dawn B.; Gay, Caryl L.; Berg, Søren; English, Coralie; Ihle-Hansen, Hege Beate & Helland, Gisle Berg [Show all 11 contributors for this article] (2026). Sleep quality, not sleep apnoea, is associated with post-stroke fatigue in acute ischemic stroke: a cross-sectional Norwegian study (NORFAST). Disability and Rehabilitation. ISSN 0963-8288. p. 11–11. doi: 10.1080/09638288.2026.2620503. Full text in Research Archive Show summary

  Purpose Post-stroke fatigue affects rehabilitation, daily activities, and quality of life. Its relationship with sleep remains unclear. We aimed in the acute stroke phase to (a) describe fatigue and sleep using self-reported and objective sleep measures, (b) describe sleep apnoea and (c) explore the associations between sleep measures and post-stroke fatigue. Material and methods This cross-sectional study examined Norwegian adults within 14 days of first ischaemic stroke. Fatigue was assessed with the Fatigue Severity Scale. Self-reported sleep factors (Pittsburgh Sleep Quality Index [PSQI], Epworth Sleepiness Scale) and objective WatchPAT measures (apnoea-hypopnea, sleep time, efficiency, REM/deep sleep) served as exposure variables. Multivariable regression models, adjusted for age, sex, mRS, and depression or anxiety symptoms, were used to examine associations between sleep and fatigue. Results Participants (n = 107, mean age 65 (SD14) years, n = 65(61%) male) had a mean NIHSS score of 2.5 [SD3.3], Fatigue Severity Scale score of 3.11 [SD1.82], and n = 71 (66%) scored as having disturbed sleep (PSQI). Mean total sleep time (n = 81) was 7.04 [SD1.46] hours and 54 (71%) had sleep apnoea. In the final multivariable model, only poor sleep quality (b = 0.45, p = 0.010) was associated with post-stroke fatigue. Conclusions Addressing sleep quality in the acute stroke phase may benefit post-stroke fatigue.

• Robertsen, Annette; Gardiner, Dale & Whetstine, Leslie (2026). Intensive care staff: the gatekeepers to donation after circulatory death. Intensive Care Medicine. ISSN 0342-4642. doi: 10.1007/s00134-025-08264-7. Full text in Research Archive Show summary

  Editorial related to Grossi et al paper on attitudes to donation after circulatory death highlighting key elements for promoting positive ICU staff support towards controlled DCD

• Helland, Gisle Berg; Ihle-Hansen, Håkon; Aamodt, Anne Hege; Leonardsen, Esten Høyland; Kaufmann, Tobias Herbert & Enriquez, Brian Anthony [Show all 13 contributors for this article] (2026). Brain age trajectories and cognition after stroke in two longitudinal cohorts. Brain Communications. 8(1). doi: 10.1093/braincomms/fcaf509. Full text in Research Archive Show summary

  Brain age is a promising neuroimaging biomarker, reflecting biological aging, but long-term trajectories and predictive value for cognitive outcomes post-stroke remains unclear. This study aimed to characterize brain aging trajectories over 8 years following a first-ever stroke and to evaluate the predictive value of brain age estimates for long-term cognitive outcomes. We analysed data from working-age (&lt;65 years) ischaemic stroke patients with small- and medium-sized strokes (lesion volumes &lt;70 ml), using two longitudinal stroke cohorts. T1-weighted MRI was acquired in the acute phase and at multiple time points up to 8 years post-stroke. Montreal cognitive assessment (MoCA) was assessed at follow-up sessions. Brain age was estimated using a state-of-the-art deep learning model. Brain-predicted age difference (Brain-PAD) was calculated as estimated brain age minus chronological age and corrected by regressing on age, age² and sex. Linear mixed-effects models examined Brain-PAD over multiple time points (whole-brain, ipsilesional and contralesional). Normalized brain volume was derived from FreeSurfer and included in the whole-brain analysis. Linear regression models evaluated whether brain age was associated with cognitive performance (MoCA) at long-term follow-up. We included 120 patients [n = 50 (42%) female, mean ± SD age at discharge was 54.9 ± 9 and National Institutes of Health Stroke Scale was 3.7 ± 6.4], with a mean follow-up of 3.4 ± 2.5 years. The mean MoCA score at follow-up was 24.7 ± 3.7. Brain-PAD increased significantly over time in the whole-brain analysis (β = 0.6/year, P &lt; 0.01), indicating 60% acceleration in brain aging after stroke, with the association remaining significant after adjusting for normalized brain volume (β = 0.5/year, P &lt; 0.01). Accelerated brain aging was observed in the ipsilesional hemisphere (β = 0.7/year, P &lt; 0.01), but not the contralesional hemisphere (β = 0.3/year, P = 0.12). Higher brain age in the acute phase of stroke predicted lower MoCA scores at follow-up (β = −0.12, P &lt; 0.05), whereas chronological age was not a significant predictor (P = 0.12). The association between brain age estimations and cognitive performance remained significant after adjusting for age, sex and education (β = −0.42, P &lt; 0.01). In this longitudinal study, we found accelerated brain aging following stroke. Furthermore, brain age was associated with cognitive outcomes several years later, highlighting its potential as an early biomarker for long-term cognitive prognosis.

• Bahus, Marianne & Larsen, Berit Hofset (2026). Behandling av selvskadere: lovregler til besvær. Kritisk juss. ISSN 0804-7375. 52(1), p. 30–55. doi: 10.18261/kj.52.1.3. Full text in Research Archive Show summary

  The Health Personnel Act Section 7 creates challenges when healthcare personnel are to treat patients with recurring self-harm without the patient’s consent. Emergency intervention with coercion results in a negative spiral for such patients and ethical challenges for healthcare personnel. A review of annual reports from clinical ethics committees shows an increased incidence of inquiries about such cases. We discuss whether healthcare personnel can refrain from providing emergency help when it is prognostically unfavorable. We also shed light on the ethical considerations that clinical ethics committees should uphold when advising. We argue that it is legally sustainable to refrain from providing emergency help in cases of repeated self-harm when such help is prognostically unfavorable.

• Kjelle, Elin; Brandsæter, Ingrid Øfsti; Porthun, Jan & Hofmann, Bjørn Morten (2026). Evaluation of a national intervention to reduce unnecessary brain magnetic resonance imaging in Norway – Effect on referral quality and justification rate. Radiography. ISSN 1078-8174. 32(2), p. 103282–103282. doi: 10.1016/j.radi.2025.103282. Full text in Research Archive
• Tammeleht, Anu; Antoniou, J.; Bernabe, Rosemarie de La Cruz; Chapin, C.; Hooff, S. van den & Mbanya, Vivian Nchanchou [Show all 10 contributors for this article] (2025). Manifestations of research ethics and integrity leadership in national surveys – cases of Estonia, Finland, Norway, France and the Netherlands. Accountability in Research. ISSN 0898-9621. 33(2). doi: 10.1080/08989621.2025.2481940. Full text in Research Archive
• Redaelli, Simone; Biller-Andorno, Nikola; Gloeckler, Sophie; Brown, Jessica; Spitale, Giovanni & Germani, Federico (2025). Mastering critical thinking skills is strongly associated with the ability to recognize fakeness and misinformation. Frontiers in Education. 10. doi: 10.3389/feduc.2025.1577692. Full text in Research Archive
• Hol, Bjørn Ottar (2025). Ethics and metaphysics of cadaveric organ conscription for transplantation. Monash Bioethics Review. ISSN 1321-2753. doi: 10.1007/s40592-025-00268-9. Full text in Research Archive Show summary

  There is a shortage of organs for transplantation resulting in long waiting lists, and many die while waiting for a new organ. Different policies are discussed for solving this problem, but the most effective, namely the conscription of cadaveric organs, the routine taking of organs from dead bodies, is considered too controversial and is therefore not implemented anywhere.I discuss the reasons for and against conscription; the former are mainly based on utilitarian arguments, while the latter are mainly based on the interests and rights of the deceased and his family. (He, his, or him, is understood to mean he/him/his or she/her/hers throughout the article.) .This article investigates whether the deceased has any interests and rights. I argue that dead bodies are mere things and thus without interests or rights. I also discuss whether the interests of the family should override the needs of patients who are on waiting lists for organs.Using arguments based on Epicurean philosophy, and supported by contemporary scholars, I conclude that dead bodies do not have interests and rights and that the possible interests and rights of the dead’s family cannot be more important than saving the lives of the people on waiting lists for organs.Thus, I argue that conscription of cadaveric organs for transplantation can be defended and should be implemented as a normal hospital practice.

• Cunningham, James; Davies, Nigel; Devaney, Sarah; Harding, Mike; Holm, Søren & Neumann, Victoria [Show all 7 contributors for this article] (2025). The development of a blockchain-based business model simulator with an application to civic medical data management. Digital Business. 5(1). doi: 10.1016/j.digbus.2025.100112. Full text in Research Archive
• Seralegne, Yemisrach Zewdie; G/Medihin, Abaraham; Hundito, Ermiyas; Adane, Hawult & Sintayehu, Bizunesh (2025). Contributions of Community Advisory Board and Experience of Study Participants in TB/MDR-TB Clinical Trial Management in Addis Ababa, Ethiopia: A Qualitative Study. Developing World Bioethics. ISSN 1471-8731. doi: 10.1111/dewb.70014. Full text in Research Archive
• Kremer, Swanny; Spreen, Marinus; Stolper, Margreet & Molewijk, Albert Christiaan (2025). Does facilitation improve moral case deliberation quality? Nursing Ethics. ISSN 0969-7330. doi: 10.1177/09697330251374396. Full text in Research Archive
• Germani, Federico & Spitale, Giovanni (2025). Source framing triggers systematic bias in large language models. Science Advances. 11(45), p. 1–13. doi: 10.1126/sciadv.adz2924. Full text in Research Archive
• Bergem, Anne Kristine & Lien, Lars (2025). Kollegastøtte ved dødsfall som skyldes overdose. In Gjersing, Linn; Clausen, Thomas & Edvardsen, Hilde Marie Erøy (Ed.), Overdoseboka. En helhetlig gjennomgang. Cappelen Damm Akademisk. ISSN 9788202852610. p. 265–277. Full text in Research Archive Show summary

  Mennesker som arbeider med mennesker med rusmiddelavhengighet, bør: -være forberedt på at pasienter/ brukere kan dø av overdose, - være forberedt på at de må støtte kolleger som mister pasienter, - diskutere overdosedødsfall med kolleger, - skape en støttende kultur på arbeidsplassen.

• Gaillard, Maxence (2025). Bioengineering ethics for the age of microphysiological systems. Frontiers in Bioengineering and Biotechnology. 13. doi: 10.3389/fbioe.2025.1497060. Full text in Research Archive
• Kloza, Dariusz; Drechsler, Laura; Fernandes, Elora; Birth, Arian; Rossi, Julien & Dewitte, Pierre [Show all 10 contributors for this article] (2025). If it ain't broke, don't fix it? Ten improvements for the upcoming tenth anniversary of the General Data Protection Regulation. Computer Law & Security Review. ISSN 2212-473X. 60. doi: 10.1016/j.clsr.2025.106251. Full text in Research Archive
• Jorem, Jacob; Førde, Reidun; Husum, Tonje Lossius; Dahlberg, Jørgen & Pedersen, Reidar (2025). Assessing decision-making capacity in clinical practice in Norway: a qualitative exploration of stakeholder perspectives. BMC Psychiatry. 25. doi: 10.1186/s12888-025-07161-z. Full text in Research Archive Show summary

  Decision-making capacity (DMC) is a widely used criterion in health law, but assessments pose challenges in practice. In Norway, lacking DMC became an additional criterion for involuntary care and treatment following comprehensive amendments to the Mental Health Care Act in 2017. Contrary to the amendments’ objectives, involuntary care rates have continued to increase after an initial reduction in 2017. Assessing DMC typically involves four abilities: understanding, reasoning, appreciating relevant information, and communicating a choice. This four abilities model was introduced to aid in DMC assessments. With limited assessment experience pre-2017, the Norwegian context offers valuable insights into how stakeholders integrate DMC into clinical practice over time. This study aimed to explore how DMC was assessed in clinical practice following the introduction of a capacity-based mental health law governing involuntary care and treatment in Norway. In 2018, semi-structured interviews and focus groups were conducted with 44 key stakeholders, including psychiatrists, specialists in clinical psychology, general practitioners, and lawyers in supervisory bodies (the Control Commission and County Governor). In 2022–23, 21 of these participants took part in individual follow-up interviews. The interviews were transcribed and thematically analysed. Data analysis generated three themes with subthemes: (1) DMC assessments primarily relied on the four abilities model in specialist care, experiencing gradual clinical adaptation with decreased importance, and exhibited variations in quality, particularly in primary care; (2) several challenges in DMC assessments, including lack of training in applying the four abilities model, ownership, continuity of care, information, and patient cooperation, with certain patient groups posing particular challenges, such as those with manic symptoms, substance misuse, and severe eating disorders; and (3) quality assurance measures needed, including systematic training and tools to improve assessment quality. Assessing DMC involves variations and several challenges across the healthcare system. While the four abilities model served as a primary basis of DMC assessments in specialist care, systematic training, validated tools, and further research seem needed to improve assessment quality and better understand factors influencing assessments. Recognising the complex interplay between legal, health service, and societal factors when implementing health law reforms seems crucial for achieving their objectives.

• Taylan, Fulya; Janhonen, Joel; Ekholm, Katja; Bajalica-Lagercrantz, Svetlana; Becker, Stefan & Benneche, Andreas [Show all 41 contributors for this article] (2025). The Nordic ChiCaP Network: An interdisciplinary approach to childhood cancer predisposition. Rare . ISSN 2950-0087. 3. doi: 10.1016/j.rare.2025.100111. Full text in Research Archive Show summary

  Testing for Childhood Cancer Predisposition (ChiCaP) syndromes is increasingly common in pediatric oncology as early identification can help adapt treatment and initiate surveillance. As such, ChiCaP testing can have medical, ethical, and psychological consequences for both the patients and their families, and present significant diagnostic challenges for pediatric oncologists. In response to these new opportunities and challenges, the Nordic ChiCaP Network was established in 2021, bringing together experts from pediatric and adult oncology, clinical genetics, molecular genetics, bioinformatics, epidemiology, psychology, anthropology, community medicine, law and ethics. Its primary goal is to advance our knowledge of ChiCaP in pediatric oncology research and care through an interdisciplinary approach. The network aims to achieve several key objectives: (1) to improve ChiCaP diagnostics, including gene-associated phenotypes and variant interpretation; (2) to advance understanding of the natural history, cancer risks, adverse treatment reactions, and comorbidities associated with ChiCaP syndromes; (3) to optimize and harmonize treatment protocols and surveillance strategies for affected patients and their families; (4) to address the ethical, legal and psychosocial aspects involved in testing, communication and counseling, diagnosing ChiCaP syndromes, and the impacts of surveillance on patients and their families; (5) to identify novel ChiCaP syndromes and explore their underlying mechanisms; and (6) to facilitate translation of research findings into clinical practice. By gathering interdisciplinary expertise and fostering collaboration across the Nordic countries, the Nordic ChiCaP Network will enhance knowledge and awareness of ChiCaP, improve early diagnosis, patient care, family support, and contribute to a better understanding of these complex genetic conditions.

• Holm, Søren (2025). Human Stem Cell-Based Embryo Models in Implantation Research: Regulation, Consistency and Potential. Biomolecules. 15(9), p. 1287–1287. doi: 10.3390/biom15091287. Full text in Research Archive Show summary

  The use of human stem cell-based embryo models (hSCBEM) in implantation research is developing rapidly. This raises regulatory and ethical issues as these models become more complex and get closer to morphological and functional identity with human embryos. This paper provides an analysis of two possible approaches to resolving the regulatory issues. The first approach is to try to achieve consistency with current regulation of embryo research, and the second approach is to elaborate the regulation of hSCBEMs based on their developmental potential. It is shown that both approaches are problematic. The consistency approach is problematic because the current regulation of embryo research is best understood as being the result of a historical, political compromise in most jurisdictions. And the approach based on assessment of developmental potential is problematic because of unavoidable epistemic uncertainty about the potential of a new hSCBEM, and because of problems in determining what constitutes a particular model, and what changes to a model makes it into a different model.

• Toh, Hui Jin; Chan, Hui Yun; Ploug, Thomas; Holm, Søren & Lysaght, Tamra (2025). Attitudes Towards the Use of Artificial Intelligence in Healthcare: A Conjoint Analysis Survey in Singapore. Asian Bioethics Review (ABR). ISSN 1793-8759. doi: 10.1007/s41649-025-00380-2. Full text in Research Archive Show summary

  Abstract Novel artificial intelligence (AI) is increasingly being used as a clinical decision support tool in healthcare. Despite AI’s growing use and improved quality in clinical decision-making, questions persist about potential harms and the lack of transparency in their algorithms. Implementation of AI technologies in healthcare must align with local norms and ethical standards if the purported benefits are to be achieved in specific contexts. Using choice-based conjoint analysis, we examined how Singaporeans evaluate different principles related to AI decision-making in healthcare. Six attributes were included: decision type, severity, explainability, quality, responsibility, and discrimination. Among 596 respondents, 51% reported fear that AI would unintentionally harm humans, while 87% feared increased surveillance. Responsibility had the highest relative importance (31.5%) for AI use in healthcare, followed by explainability (27.7%) and discrimination (15.9%). The most valued attribute levels were AI recommendations being as explainable as doctors’, doctors retaining responsibility for treatment decisions, and AI systems being tested for discrimination. Our respondents showed higher levels of trust, hope, and fear toward AI, with a stronger preference for explainability over doctor responsibility. While having AI outperform doctors in generating clinical suggestions is desirable, principles such as explainability, human oversight, and fairness are more important for the people whose lives AI will impact.

• Jorem, Jacob; Førde, Reidun; Husum, Tonje Lossius; Dahlberg, Jørgen & Pedersen, Reidar (2025). Factors influencing decision-making capacity assessments in involuntary care and treatment in Norway: A qualitative exploration of multi-stakeholder perspectives. International Journal of Law and Psychiatry. ISSN 0160-2527. 104. doi: 10.1016/j.ijlp.2025.102157. Full text in Research Archive Show summary

  Background Decision-making capacity (DMC) is a widely used criterion in health laws to balance respect for patient autonomy with protection from the potential consequences of treatment decisions. In 2017, lacking DMC was introduced as an additional criterion for involuntary care and treatment following comprehensive amendments to the Norwegian Mental Health Care Act. Despite the amendments aiming to reduce involuntary care and treatment rates, national health registry data indicate continued rising rates along the pre-2017 trajectory after an initial reduction in 2017. While previous studies suggesting varying DMC assessment quality, little is known about the potential factors influencing these variations. Aims To identify factors influencing DMC assessments after introducing a capacity-based mental health law governing involuntary care and treatment. Methods 60 purposively sampled stakeholders, including patients, families, health professionals, and lawyers, participated in semi-structured interviews and focus groups in 2018, with 26 of these participating in follow-up interviews in 2022–23. The transcribed interviews were analysed using thematic analysis. Results Data analysis generated four themes: 1) available resources' influence on DMC assessments; 2) health professionals' values and practices regarding involuntary care; 3) legal interpretations by supervisory bodies regarding involuntary care; and 4) political signals from the health authorities regarding involuntary care. Conclusion DMC assessments appear to be influenced by several factors, including resource availability, health professionals' values and practices, legal interpretations by supervisory bodies, and political signals from health authorities. Combined with a lack of systematic training and validated tools, these factors may have raised the threshold for accessing mental healthcare beyond what systematic DMC assessments would suggest, contributing to increased illness severity among patients and rising involuntary care rates post-2017. Further research is needed to better understand the complex dynamics involved in DMC assessments and how to effectively implement capacity-based health laws.

• Norheim, Irene; Pedersen, Reidar; Selle, Maria Lie; Røssberg, Jan Ivar; Hestmark, Lars & Heiervang, Kristin Sverdvik [Show all 13 contributors for this article] (2025). Effectiveness of implementing family involvement on patient outcomes in individuals with psychotic disorders: a pragmatic cluster randomised controlled trial. BMC Psychiatry. 25(1). doi: 10.1186/s12888-025-07501-z. Full text in Research Archive Show summary

  Abstract Background The purpose of this sub-study, as part of the Implementation of guidelines on Family Involvement for persons with Psychotic disorders (IFIP) trial, was to examine the effectiveness of family interventions (FIs) implemented through an implementation support program (ISP) on patients’ outcomes. Methods The IFIP trial is a cluster randomised controlled trial where 15 Community Mental Health Centre units were randomly allocated either to the ISP, which included FIs as clinical interventions, implementation strategies, and implementation interventions, or to treatment as usual (TAU). In the control arm, patients could have access to FIs. Patients with psychotic disorders in both arms were asked to complete questionnaires at inclusion, 6- and 12 months. The primary outcome was patients’ difficulties in interpersonal relationships measured with the Relationships subscale of Behaviour and Symptom Identification scale. The secondary outcomes were patients’ mental health and functioning, perceived expressed emotions, recovery, and quality of life. Linear mixed-effects models were used to analyse differences in change over time between the two arms. Results We included 231 patients (135 from the intervention units; 96 from the control units). Except for the first 24% of the 6 months questionnaires, the 6- and 12-month data were collected during the COVID-19 pandemic. There were no significant differences in the primary outcome, difficulties in interpersonal relationships at 12 months, between the intervention and control arms (Cohen’s d = -0.19, p  = 0.2). The secondary outcomes showed less perceived criticism from the relatives (Perceived Criticism sub-score; d = − 0.4, p  = 0.01) and reduced difficulties in overall functioning (Health of the Nation Outcome Scale; d = − 0.29, p  = 0.01) in the intervention arm compared to the control arm at 12 months. Conclusion The FIs, implemented through the ISP, did not achieve significant decreases in patients’ difficulties with interpersonal relationships. However, this sub-study indicates that FIs in routine mental health practices can nurture a more positive family environment and enhance the patient’s process toward improved functioning. The complexity of the study design, and the restrictions due to COVID-19, may have diminished the implementation and effectiveness of the measured FIs for the patients. Trial registration ClinicalTrials.gov Identifier NCT03869177. Registered 2019-02-28.

• Löfström, Erika; Lindemann, Tom; Blom, Fenneke; Evans, Natalie; Hoven, Mariette van den & Inguaggiato, Giulia [Show all 13 contributors for this article] (2025). Fostering Research Integrity through Training: The training materials of four EU-funded projects through the lens of pedagogical underpinnings and three taxonomies of learning. Open Research Europe. 5, p. 301–301. doi: 10.12688/openreseurope.20826.1. Full text in Research Archive Show summary

  Background This article provides an analysis of the pedagogical underpinnings that characterise the research integrity (RI) training approaches and materials developed by four European Union - funded projects. The approaches taken by these projects include a dialogical approach, an empowerment approach, a virtue ethics approach, and a constructivist case-based approach. We analysed the materials/trainings created in the projects. In doing so, we propose how to make use of a structured way of working with learning objectives, in order to ensure that research integrity training meets the needs of its target groups. Methods We applied qualitative, deductive content analysis in which we analysed the learning objectives stated in the training schemes of the four projects. A total of 46 learning objectives were analysed using three learning taxonomies, namely the revised Bloom's Taxonomy, the SOLO Taxonomy, and the Taxonomy of Significant Learning. Results The results show that the four RI trainings make use of either a constructivist or a socio-constructivist understanding of learning, implement activating and engaging learning activities, and emphasise high-order learning objectives. Conclusions The analysis suggests that taxonomies are applicable to various pedagogical underpinnings and can help trainers to communicate the objectives of training and learners to relate their expectations to the objectives. We identify implications for training design and suggest recommendations for training developers. It is advisable to pay attention to learning objectives dedicated to foster the higher levels of learning and understanding. Less commonly applied taxonomies in the context of integrity training, such as the Taxonomy of Significant Learning can help to identify relevant learning objectives both for trainers as well as learners. Research cultures and disciplinary differences are generally not spelled out at the level of learning objectives highlighting the need to consider these explicitly in training implementation.

• Brøderud, Linn; Romøren, Maria; Hermansen, Karin Berg; Sævareid, Trygve Johannes Lereim; Thoresen, Lisbeth & Pedersen, Reidar (2025). Barriers and facilitators in implementing advance care planning for frail older patients acutely admitted to geriatric hospital units: a nested qualitative study. Frontiers in Health Services. 5. doi: 10.3389/frhs.2025.1646541. Full text in Research Archive Show summary

  Background: Appropriate communication with patients is increasingly crucial in a growing elderly population to prevent both over- and undertreatment. Advance care planning (ACP) is recognized as a valuable communication process for patients, their relatives and healthcare professionals that facilitates future care and medical decision-making. Despite its importance, the uptake remains low, particularly among frail, older patients in hospitals. Methods: This qualitative substudy is nested within a cluster randomized controlled trial. Data collection involved eight semi-structured interviews conducted in acute geriatric hospital units receiving our implementation support program, along with informal data from interactions with the units during the implementation process. The aim was to explore healthcare professionals' perspectives on the barriers and facilitators to ACP implementation and their experiences with the implementation support program. A semi-structured interview guide was used. The data was analyzed using content analysis. Results: Factors influencing ACP implementation were identified at three levels: a) the organizational level, b) the national level, and c) the clinical level. Participants recognized the critical role of timing, context, and patients' capacity. However, there was meaningful opportunities for ACP conversations in acute geriatric units. Overall, the experiences underscored the complex interplay of individual motivation and interest, organizational support, prioritization, available time and resources, and systemic factors that influence the integration of ACP into clinical practice, as well as the fact that research can act as both a barrier and a facilitator in implementation efforts. Discussion: This study illustrates the significant challenges in implementing ACP in acute hospital care. Despite a generally positive perception of ACP, its implementation was hindered by barriers such as overwhelming workload, production-oriented healthcare, the biomedical model, and lack of prioritization. These factors creates a cycle where short-term demands overshadow preventive and patient-centered interventions, limiting their perceived and documented benefits. Breaking this cycle will likely require targeted investment in the implementation of complex interventions.

• Magelssen, Morten (2025). Bør dødshjelp legaliseres i Norge? En kritisk lesning av Moen og Sterris «Aktiv dødshjelp. Etikk ved livets slutt». Etikk i praksis. ISSN 1890-3991. 19(1), p. 7–24. doi: 10.5324/eip.v19i1.5990. Full text in Research Archive Show summary

  Ole Martin Moen og Aksel Braanen Sterris bok «Aktiv dødshjelp. Etikk ved livets slutt» er den beste og grundigste argumentasjonen på norsk for legalisering av dødshjelp til nå. Denne artikkelen er basert på en kritisk lesning av boken. Kritikken struktureres av fem tematiske «spor» som dødshjelpsdebatten gjerne følger. Jeg argumenterer for at Moen og Sterri ikke har lagt tilstrekkelig vekt på den moralske betydningen av selve dødshjelpshandlingen. Argumentet om at legalisering av dødshjelp kan legge «press på de svake» er et enda sterkere argument enn hva forfatterne får frem. Adgang til dødshjelp kan true profesjonsetiske holdninger nødvendige for lege-pasientrelasjonen. Ved god palliasjon samt klok praktisering av behandlingsbegrensning kan det opplevde behovet for dødshjelp reduseres sterkt. Til sist er det svakheter ved den konkrete modellen for legalisering som Moen og Sterri foreslår; modellen ligger tett opp mot det nederlandske systemet, og er dermed sårbar for innvendinger mot dette.

• Magelssen, Morten; Bringedal, Berit H.; Rø, Karin Isaksson & Dalum, Helene Seljenes (2025). Holdninger til dødshjelp blant leger i Norge. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 145. doi: 10.4045/tidsskr.25.0053. Full text in Research Archive Show summary

  Bakgrunn Dødshjelp (eutanasi og assistert selvmord) er ulovlig i Norge. Norske legers syn på dødshjelp ble sist undersøkt i 2016. Vi har nå på ny undersøkt legers holdninger til dødshjelp. Materiale og metode Vi sendte ut en spørreundersøkelse til et utvalg yrkesaktive leger. Legene ble bedt om å ta stilling til seks påstander om legalisering av dødshjelp og tre påstander om vilje til å utføre eller bidra til dødshjelp samt om holdning til reservasjonsrett. Resultater Svarprosenten var 2 010/2 534 (79,3 %), og svarene fra 2 004 leger under 70 år ble inkludert. 723 (36,1 %) svarte at de var svært uenig i at «legeassistert selvmord bør tillates for personer som har en dødelig sykdom med kort forventet levetid». 232 (11,6 %) var svært enig i påstanden. Eldre respondenter var oftere avvisende til legalisering. 410 (20,5 %) var villige til å bidra til legeassistert selvmord, og 1 796 (89,6 %) ønsket reservasjonsrett i forbindelse med dødshjelp hvis dødshjelp skulle bli tillatt. Fortolkning En stor andel av legene i Norge er negative til å legalisere dødshjelp. Samtidig ser det ut til å være en bevegelse i retning av mindre motstand mot legalisering siden 2016.

• Fredheim, Olav Magnus Søndenå; Gravdahl, Eva-Kristin Norum; Skulberg, Ingeborg M & Magelssen, Morten (2025). Attitudes Toward Euthanasia and Physician-Assisted Suicide Among Norwegian Palliative Care Physicians. Palliative Medicine Reports (PMR). 6(1), p. 415–423. doi: 10.1177/26892820251372012. Full text in Research Archive Show summary

  Background: Data from other countries have indicated that palliative care physicians are more opposed to assisted dying compared with other physicians. However, little is known about reasons for support/opposition among palliative care physicians. Objectives: To explore Norwegian palliative care physicians’ attitudes toward assisted dying, with focus on filling knowledge gaps regarding reasons for support/opposition. Methods: The study is a cross-sectional descriptive survey. All 285 members of the Norwegian Association for Palliative Medicine were invited by e-mail to participate. To allow comparison with previous data, most questions and response alternatives were similar to a 2024 study of Norwegian physicians. Results: Among the 117 respondents opposition toward assisted dying was observed with 85 (73%) strongly disagreeing and 14 (12%) somewhat disagreeing with legalization of physician-assisted suicide for patients with short life expectancy. There was a clear pattern of less support for assisted dying if indications were wider, with only one respondent partially agreeing that assisted dying should be legalized for patients without severe illness who are tired of life and want to die. The most common reason for opposition was assisted dying representing a breach with professional ethics (88 subjects). The most common reason for support was that legalization could provide a safety for patients and next of kin that suffering could be avoided (14 subjects). Discussion: A large majority of Norwegian palliative care physicians reject the legalization of assisted dying. Among the small minority who support assisted dying, most believe it should be limited to patients with a short life expectancy.

• Torvund, Solveig Kristine Kolstad; Thoresen, Lisbeth; Magelssen, Morten & Fredheim, Olav Magnus Søndenå (2025). Conceptual barriers to palliative sedation: insights from focus group interviews with specialist palliative care professionals. BMC Palliative Care. 24(1). doi: 10.1186/s12904-025-01931-y. Full text in Research Archive Show summary

  Palliative sedation is considered an essential measure when other methods cannot provide sufficient symptom control in end-of-life. Prior research suggests that health care professionals find boundaries between palliative sedation, routine symptom management and euthanasia ambiguous. Appropriate implementation of palliative sedation depends on palliative care clinicians being confident in conceptual understanding of palliative sedation. The aim of this study was to understand specialist palliative care professionals' conceptualization of distinctions between symptom management, palliative sedation, and euthanasia; how perceived boundary ambiguities act as barriers to timely initiation of palliative sedation; and potential strategies to overcome these barriers. Methods This is an explorative qualitative phenomenological study, based on focus group interviews, utilizing reflexive thematic analysis. Four focus groups were interviewed at specialist palliative care departments across four Norwegian hospitals. Participants were 11 nurses and 12 physicians with at least one year of experience within specialist palliative care. Results Through thematic analysis two core themes were developed; the distinction between symptom management and palliative sedation, and the distinction between palliative sedation and euthanasia. Important sub-themes were definitional uncertainties, complexity of gradual medication titration, timing of sedation, indications for sedation, communication, and concerns about hastening death. Conclusion Even within specialist palliative care, different end-of-life treatment concepts are not experienced clear-cut. These conceptual ambiguities impede appropriate initiation of palliative sedation. Overcoming such barriers requires multi-level interventions: enhancing practitioners' definitional knowledge, fostering awareness of clinical intention during end-of-life treatment, promoting interprofessional dialogue, and developing more explicit clinical guidelines.

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• Fystro, Joar Røkke (2026). Bør dagens vernepleiere hete noe annet i morgen? Vernepleier.no. Full text in Research Archive
• Hofstad, Tore (2026). Six-Year Health, Socioeconomic, and Criminal Justice Outcomes Following Compulsory Mental Health Care in Norway: A Nationwide Registry Study. Full text in Research Archive Show summary

  Aims: To describe and compare six-year health, criminal justice, and socioeconomic outcomes across three compulsory care pathways: community treatment orders (CTO), compulsory hospitalisation, and short-term compulsory observation, contrasted with voluntary care and population control cohorts. Methods: This nationwide registry study followed 186 832 individuals (ages 18–65) with specialist mental health contact in Norway during 2015–16. Individuals were hierarchically assigned to mutually exclusive groups: CTO (n = 3 346), compulsory hospitalisation (n = 2 921), compulsory observation (n = 2 552), voluntary care (n = 177 504), and population controls (n = 135 520). We estimated sex-specific adjusted probabilities for 14 outcomes across mortality, clinical risk, safety, and socioeconomic domains using binomial logistic regression. Results: All compulsory care groups faced significantly higher six-year burdens across mortality, self-harm, and socioeconomic disadvantage than voluntary patients and controls. Compulsory observation, though brief, was associated with the highest long-term risks for self-harm, substance use, and external-cause mortality. CTOs were characterised by profound socioeconomic marginalisation, although nearly onefifth of recipients combined disability benefits with employment income. Conclusion: Legal pathways identify distinct high-risk trajectories. Short observation episodes often flag profound unresolved risk rather than transient crises, requiring systematic post-discharge follow-up. For those on CTOs, the Results underscore a need for sustained vocational and social rehabilitation.

• Hofstad, Tore (2026). Hva skjer seks år etter tvungent psykisk helsevern? En registerbasert populasjonsstudie. Full text in Research Archive
• Adams, Jonathan (2026). AI & Ethics. Full text in Research Archive
• Fystro, Joar Røkke (2026). Fysioterapi som investering eller helsetjeneste? Fysioterapeuten. ISSN 0016-3384. Full text in Research Archive Show summary

  - Fysioterapien er bedre tjent med å promotere seg som en basal og nødvendig helsetjeneste med helsefaglig nytte, ikke en investering i samfunnsøkonomi, skriver Joar Røkke Fystro.

• Nordhaug, Marita & Nortvedt, Per (2026). Dødshjelp: Like lidelser – ulike rettigheter. Full text in Research Archive Show summary

  Det innføres en rettighet som kompromisser med et grunnprinsipp i norsk helsetjeneste: Likeverdig tilgang til hjelp basert på medisinske behov – ikke på evnen til å be om hjelp.

• Hofmann, Bjørn Morten & Kjelle, Elin (2026). Medisinsk Overaktivitet – Riktig bruk av radiologiske tjenester. Full text in Research Archive
• Westbye, Siri Færden (2026). Forhåndssamtaler – på sykehjem og andre steder i helsetjenesten. Full text in Research Archive
• Westbye, Siri Færden (2026). Forhåndssamtaler. Full text in Research Archive
• Harring, Astrid Karina V. & Aase, Christina (2026). Hjertestans og HLR minus på helse- og omsorgsinstitusjoner. doi: https:/nrr.org/images/pdf/2026/1_program_nrr_kongress_juni_2026.pdf. Full text in Research Archive
• Dal-Ré, Rafael & Holm, Søren (2026). Would a single centralized ethical review in Europe be feasible for multinational trials in public health emergencies? European journal of internal medicine. ISSN 0953-6205. doi: 10.1016/j.ejim.2026.106949. Full text in Research Archive
• Cairns, Patrick; Knapstad, Ida Katrine; Ishaq, Bushra; Bache-Mathiesen, Lena Kristin; Wangensteen, Urd Teresia & Pedersen, Reidar [Show all 10 contributors for this article] (2026). Norway Update – Nordic ChiCaP symposium. Full text in Research Archive Show summary

  Conference talk at symposium for members of the Nordic Childhood Cancer Predisposition collaboration group – 13th-14th April 2026.

• Cairns, Patrick; Ishaq, Bushra; Knapstad, Ida Katrine; Pedersen, Reidar; Hofmann, Bjørn Morten & Wangensteen, Urd Teresia [Show all 10 contributors for this article] (2026). Hopes and Concerns of Adolescent Patients and their Caregivers Related to Genetic Predisposition Testing in Childhood Cancer Care: A Three-Year Longitudinal Follow-Up. Full text in Research Archive
• Cairns, Patrick; Ishaq, Bushra & Lie, Hanne Cathrine (2026). Psychosocial Group – Literature resource. Full text in Research Archive
• Fystro, Joar Røkke (2026). Får hakeslepp av sykehusgebyr: – Helt sinnssykt! - adressa.no. [Journal]. Adresseavisen. Full text in Research Archive Show summary

  Hvis du ikke møter opp til oppsatt time, kan du måtte punge ut nær 2 000 kroner. Det får flere til å reagere.

• Fystro, Joar Røkke (2026). Vet folk flest best? Innbyggerundersøkelser i politikkutforming. Full text in Research Archive Show summary

  Politikk handler om å prioritere verdier. Demokrati handler om folkelig deltakelse i politikken. Men hvordan er forholdet mellom folks meninger og politiske beslutninger? Og mer spesifikt, på hvilken måte bør innbyggerundersøkelser brukes i politikkutformingen?

• Dietrichs, Erik Sveberg; Rogne, Tormod; Solberg, Carl Tollef & Nordengen, Kaja (2026). Norge trenger flere forskere, da må vi rekruttere tidligere. Full text in Research Archive Show summary

  KRONIKK: For første gang på 55 år er det nedgang i antall forskere. Ved norske universiteter og høyskoler var det 770 færre forskere i 2024 sammenlignet med 2023.

• Nordhaug, Marita & Nortvedt, Per (2026). Dødshjelp rokker ved helsetjenestens verdigrunnlag | Sykepleien. Sykepleien.no. Full text in Research Archive Show summary

  Debatten om dødshjelp handler ikke bare om enkeltmenneskets rettigheter, men om hvilke verdier helsetjenesten skal bygge på. Når beslutningskompetanse gjøres til et vilkår, oppstår et rettferdighetsproblem som enten åpner for urettferdig forskjellsbehandling eller for en utvidelse som kan true sårbare liv. Begge deler utfordrer prinsippene om likeverd og likebehandling i helsetjenesten.

• Fystro, Joar Røkke (2026). Hvor går grensen for pasientansvar i fysioterapi? Nytt postdoktorprosjekt skal finne svar. [Journal]. Fysioterapeuten. Full text in Research Archive Show summary

  Hvor mye ansvar kan, og bør, pasienter forventes å ta for egen behandling? Det spørsmålet står sentralt i et nytt postdoktorprosjekt ved Senter for medisinsk etikk (UiO) i regi av fysioterapeut og forsker Joar Røkke Fystro.

• Fystro, Joar Røkke (2026). Fraværsgebyret bør revideres kraftig. Full text in Research Archive
• Solberg, Berge & Magelssen, Morten (2026). Abort og fosterdiagnostikk. Full text in Research Archive
• Eberhard-Gran, Malin; Wang, Catharina Elisabeth Arfwedson & Lien, Lars (2026). Retningslinjer redder ingen, hvis mor står alene hjemme. doi: https:/www.dagensmedisin.no/depresjon-fodselsomsorg-psykisk-helse/retningslinjer-redder-ingen-hvis-mor-star-alene-hjemme/727668?fbclid=IwZnRzaAPXD1lleHRuA2FlbQIxMQBzcnRjBmFwcF9pZAo2NjI4NTY4Mzc5AAEequ7a6qyXKHYX4gZ4_D7dtKNiSGVCJYOsPZo0XL5bWVY8PIWJgGL1Js3TJBM_aem_LS9T19Jg4-5tHxbyFSWrfw. Full text in Research Archive
• Baños, David & Bernabe, Rosemarie de La Cruz (2025). En akademisk og medisinsk skandale. Forskersonen.no. Full text in Research Archive Show summary

  DEBATT: At seniorforskere med betydelig makt og innflytelse ikke ivaretar pasienters og forskningsdeltakeres rettigheter, og ikke anerkjenner sakens alvor, er dypt urovekkende.

• Ishaq, Bushra; Cairns, Patrick; Knapstad, Ida Katrine; Bache-Mathiesen, Lena Kristin; Bentzen, Heidi Beate & Pedersen, Reidar [Show all 10 contributors for this article] (2025). The PROTECT-CARE study: Psychosocial, communication, ethical and legal aspects of childhood cancer predisposition testing in clinical care. Full text in Research Archive
• Cairns, Patrick; Ishaq, Bushra; Knapstad, Ida Katrine; Hofmann, Bjørn Morten; Bentzen, Heidi Beate & Wangensteen, Urd Teresia [Show all 9 contributors for this article] (2025). Exploring psycho-social-ethico-legal issues related to genetic predisposition testing in pediatric cancer – the PROTECT-CARE study. Full text in Research Archive
• Pedersen, Reidar (2025). Hvordan unngå bruk av tvang i daglig pasientkontakt - Å møte motstand. Full text in Research Archive
• Pedersen, Reidar (2025). Lovendringer i pasient- og brukerrettighetsloven og psykisk helsevernlovenfom 1. juni 2026. Full text in Research Archive
• Pedersen, Reidar (2025). Kasuistikker - Arkiv og database e.l. Full text in Research Archive
• Pedersen, Reidar (2025). Veileder behandlingsavklaringer, forhåndssamtaler og kjernejournal/kritisk info. Full text in Research Archive
• Pedersen, Reidar (2025). Prioriteringsmeldingen - kommentarinnlegg. Full text in Research Archive
• Pedersen, Reidar (2025). Paneldialog – case. Full text in Research Archive
• Pedersen, Reidar (2025). Etiske perspektiv på gode valg i livets dilemmaer. Full text in Research Archive
• Pedersen, Reidar (2025). Vurdering av samtykkekompetanse. Full text in Research Archive
• Pedersen, Reidar (2025). Når sårbare voksne utsettes for vold, overgrep eller utnytting - jussen, etiske dilemma, prinsipper og systematiske drøftinger. Full text in Research Archive
• Pedersen, Reidar (2025). Avslutning og veien videre. Full text in Research Archive
• Pedersen, Reidar (2025). Om prosjektet «Implementering av forhåndssamtaler i akuttgeriatriske enheter». Full text in Research Archive
• Pedersen, Reidar (2025). Behandlingsavklaringer, dødshjelp og ny nasjonal veileder. Full text in Research Archive
• Pedersen, Reidar (2025). Beslutningskompetanse, sykdomsinnsikt og lovendringsforslaget. Full text in Research Archive
• Pedersen, Reidar (2025). Medisinsk etikk og palliasjon. Full text in Research Archive
• Pedersen, Reidar (2025). Forhåndssamtaler - innføring og praktiske øvelser. Full text in Research Archive
• Pedersen, Reidar (2025). Pårørendesamarbeid og sosial innovasjon i velferdstjenestene. Full text in Research Archive
• Pedersen, Reidar (2025). Dialogmøte om sykehjemsundersøkelse. Full text in Research Archive
• Pedersen, Reidar (2025). Den neste teknologirevolusjonen? Paneldiskusjon. Full text in Research Archive
• Boriani, Giuseppe; Mei, Davide Antonio; Lip, Gregory Y.H.; Bonini, Niccolò; Vitolo, Marco & Imberti, Jacopo Francesco [Show all 86 contributors for this article] (2025). Artificial intelligence in patients with atrial fibrillation to manage clinical complexity and comorbidities: the ARISTOTELES project. European Heart Journal. ISSN 0195-668X. 46(9), p. 775–777. doi: 10.1093/eurheartj/ehae792. Full text in Research Archive
• Cohn, Betty; Doerr, Megan; Feliciano, Pamela; Fullerton, Stephanie M.; Hendriks, Saskia & Holm, Søren [Show all 13 contributors for this article] (2025). Transparency and ongoing communication with participants in brain organoid research: Consensus of an interdisciplinary working group. Stem Cell Reports. ISSN 2213-6711. 20(9), p. 102546–102546. doi: 10.1016/j.stemcr.2025.102546. Full text in Research Archive Show summary

  Stem cell-based models of the human brain benefit from biospecimens that can be used for a broad range of future research. But current regulations do not address the desire of research participants to remain engaged beyond initial biospecimen donation. We present practicable strategies for engaging participants while preserving scientific potential.

• Nyttingnes, Olav; Hofstad, Tore; Johnsen, Erik; Strømme, Maria Fagerbakke; Markussen, Simen & Killackey, Eóin [Show all 15 contributors for this article] (2025). Study protocol for Controversies in psychiatry – antipsychotics: Long term outcomes and causal modelling of antipsychotic treatment using Norwegian Registry data. doi: 10.12688/f1000research.166156.1. Full text in Research Archive Show summary

  Background Antipsychotics are effective in reducing acute psychotic symptoms and preventing relapse in stabilized patients. However, their use remains controversial due to significant side effects and limited efficacy in some patients. This controversy is further compounded by some patients’ preferences to avoid or discontinue use, and the practice of involuntary admissions and antipsychotic medication treatment. Evaluating long-term outcomes, optimal discontinuation strategies, and the risks associated with managing first-episode psychosis without antipsychotics is challenging in randomized controlled trials (RCTs) due to ethical and safety concerns, participant attrition, and feasibility constraints. Real-world clinical practices vary widely in the duration, type, and non-use of antipsychotics due to provider variation. Methods We present a study that will utilize and link multiple longitudinal Norwegian national registry datasets, encompassing mental health care use, prescriptions, hospital emergency care contacts, injury presentations, educational outcomes, employment, criminal justice system contacts, and mortality. These data will enable descriptive analyses of outcomes for patients receiving different types, dosages, durations, and total exposures to antipsychotics, as well as for patients managed without antipsychotics. We also plan to estimate variations in public spending and societal costs. Variation in prescriber preferences will serve as quasi-randomization, allowing for causal inference after testing assumptions. Conclusions This study will provide empirical evidence to inform patients, carers, service providers, and policymakers in making complex decisions about antipsychotic maintenance treatment. Ethics and dissemination Ethic approval was granted by the Regional Ethical Committee for Medical and Health Services Research, Norway (REC South East, Committee D, REK 10895). Data will be pseudonymized for the project. The project group is committed to publishing all relevant findings in peer-reviewed journals, including null findings.

• Blystad, Julie Borge; Lea, Marianne & Hofmann, Bjørn Morten (2025). Å fjerne en diagnose kan i mange tilfeller være helsefremmende. [Journal]. Psykologisk.no. doi: https:/psykologisk.no/2025/11/a-fjerne-en-diagnose-kan-i-mange-tilfeller-vaere-helsefremmende/. Full text in Research Archive
• Adams, Jonathan & Hofmann, Bjørn Morten (2026). Responsible Explainable Artificial Intelligence in Medicine: Towards a Framework for Ethical and Epistemic Assessment. Universitetet i Oslo. ISSN 9788234808975. Full text in Research Archive Show summary

  This thesis is about responsible explainable artificial intelligence (AI) in medicine, aiming to build a principle-based framework to assess the knowledge that AI offers in the medical field and the ethical implications of AI in medicine. A key challenge that motivates this work is AI explainability: do we understand why AI systems produce the results that they do, and if not, then is that a problem for medical ethics? The thesis argues that medical ethics should adopt the emerging principle of ‘explicability’ to enable us to make ethical problems visible in AI systems and therefore connect traditional ethical principles to concrete responsibilities. The thesis argues that the principle of explicability, rather than being an unnecessary addition, resembles more established principles in its key focus on connecting abstract theory to clinical practice. The thesis also proposes a structured tool for evaluating medical AI, called ‘the ethical-epistemic matrix’. While ethical principles are often applied to medical AI, this matrix includes ‘epistemic’ (i.e. knowledge-related) principles, which assess the kinds of knowledge that AI systems can provide. The epistemic principles put forward are: accuracy, consistency, relevance and instrumental efficacy. This thesis also shows how the matrix can be used to explore the implications of medical AI by applying its principles to medical AI systems in general and for the specific case of sleep apnoea detection, which is relevant to the Respire project of which this PhD work is part. Overall, this thesis advances both the conceptual and methodological foundations for evaluating responsible explainable AI in medicine and provides a practical framework within which to conduct such evaluation. These contributions can support further development of principle- and matrix-based approaches to the evaluation of medical AI, as well as interdisciplinary collaborations aiming to implement responsible explainable medical AI in practice.

• Jovana, Cvetkovic, & Agledahl, Kari Milch (2026). Ethics in the Operating Room: A Qualitative Study of Intraoperative Ethical Issues Narrated by Practicing Surgeons. UiT Norges arktiske universitet. Full text in Research Archive Show summary

  --- Abstract and files will be published: 2029-05-18

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